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Pre-Reg Exam > Stuff to Learn - Notes > Flashcards

Stuff to Learn - Notes Flashcards

1
Q

What Chads-Vasc scores would warrant anticoagulation treatment for men & women with AF ?

A 
Women = score of 2 or more 
Men = score of 1 or more
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2
Q

What are the treatment options for rate control in AF?

A

Monotherapy 1st Line: Β Blocker OR Rate-Limiting CCB (or Digoxin if have congestive heart failure/sedentary)
Dual Therapy 2nd Line: B blocker/CCB with Digoxin (HF ideally B blocker licensed for HF with Dig)
3rd Line: Rhythm Control

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3
Q

True or False, rate-limiting CCB’s are contraindicated in HF?

A

True.

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4
Q

Why should you wait before doing cardio version for AF if symptoms present for > 48 hours?

A

Increased risk of stroke:

  • wait and anticoagulate 3 weeks before + 4 weeks after cardio version
  • give rate control in the meantime
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5
Q

What are the drugs used in pharmacological cardio version?

A

Flecainide - if no structural/ischaemc heart disease

Amiodarone - if there is structural heart disease, start 4 weeks before electrical cardioversion + continue up to 12 months

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6
Q

Treatment options of paroxysmal atrial fibrillation?

A

paroxysmal = episode resolves in 48 hrs without tx

  • symptomatic: β blocker
  • pill in pocket (infrequent episodes): flecainide/propafenone
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7
Q

Treatment options for paroxysmal supraventricular arrhythmias

A

will terminate spontaneously

1st Line: Adenosine (C/I in asthma, COPD, HF)

2nd Line: Verapamil IV

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8
Q

Treatment in ventricular tachycardia

A

Medical Emergency

  • Direct Cardioversion + CPR
  • IV Amiodarone + Cardioversion repeated
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9
Q

Flecainide/Propafenone?

A

Contraindications: Heart Block, Structural Heart Disease, Heart Failure

Interactions: other anti-arrhythmias - can cause bradycardia, weaken the heart and QT prolongation (cardio-depression)

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10
Q

Adenosine

A

Used for Paroxysmal Supra-ventricular Tachycardia’s - injected to restore

  • Contraindicated: Asthma, COPD, Heart Failure, Heart Block
  • Side Effects: once injected - bradycardia + asystole, initially get a sense of impending doom and sinking feeling in the chest (but short duration of action)
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11
Q

Sotalol

A

Water-Sol Β Blocker - main thing = QT !

  • Contraindicated: Long QT Syndrome
  • Cautions: severe diarrhoea/prolonged - potassium changes and can cause arrhythmias
  • Side Effects: life threatening arrhythmias due to QT !
  • Renally Cleared - need dose reductions CrCl < 60
  • Monitoring: ECG, potassium, QT
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12
Q

Diltiazem/Verapamil - Contraindications

A
  • Contraindications: HEART FAILURE, bradycardia, heart block
  • Cautions: poor LV function - can precipitate HF
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13
Q

Which CCB can be used in heart failure?

A

ONLY Amlodipine

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14
Q

Diltiazem/Verapamil - Interactions

A
  • Β Blockers - can cause heart failure, bradycardia, systole
  • Grapefruit Juice
  • Statins
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15
Q

Dilitiazem/Verpamil Side Effects

A
  • CONSTIPATION
  • hypotension/bradycardia, cardiac failure
  • other CCB side effects such as ankle swelling, flushing, headache, palpitations

Verapamil is MORE cardioselective than Diltiazem - so will have less of the other CCB side effects like ankle swelling

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16
Q

Pharmacological Prophylaxis for Surgical Patients

A

LMWH/Fondaparinux/Heparin

  • 7 days post-op for general surgery
  • 28 days post-op for abdominal cancer surgery
  • elective hip: LMWH for 10 days + Aspirin for 28 days OR LMWH for 28 days OR Rivaroxaban
  • elective knee: low-dose aspirin for 14 days OR Rivaroxaban
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17
Q

Pharmacological Prophylaxis in Medical Patients

A

1st Line: LMWH
2nd Line: Fondaparinux

Renal Impairment: Heparin

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18
Q

Initial Treatment of DVT - doses

A
  • Apixaban: 10mg BD for 7 days then 5mg BD
  • Rivaroxaban: 15mg BD for 21 days then 20mg OD
  • Edoxaban: 5 days of LMWH then 60mg OD
  • Dabigatran: 5 days of LMWH then 150mg BD
  • Warfarin: LMWH + Warfarin for 5 days/until INR at least 2 for 2 readings then continue Warfarin
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19
Q

Which DOACs require dose adjustments for VTE doses?

A
  • Apixaban - don’t reduce dose based on age (80) or weight (< 60kg) like you do in AF
  • Dabigatran - 110-150mg BD if 75-79 years OR if there’s renal impairment OR if taking Amiodarone/Verapamil
  • Edoxaban - 30mg OD if < 60kg
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20
Q

How long to continue maintenance of VTE treatment?

A

3 months if provoked

> 3 months if unprovoked

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21
Q

Stroke Prevention in AF - doses

A
  • Apixaban: 5mg BD
  • Rivaroxaban: 20mg OD
  • Edoxaban: 60mg OD
  • Dabigatran: 150mg BD

/Warfarin - according to INR

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22
Q

Which DOACs require dose adjustments for VTE doses?

A

Apixaban: 2.5mg BD IF have any 2 of

  • > 80 years
  • < 60kg
  • Cr > 133 (CrCl 15-30)

Rivaroxaban: 15mg OD IF CrCl 15-49

Edoxaban: 30mg OD IF

  • < 60kg
  • CrCl 15-50
  • Concomitant tx with Dronedarone, Erythromycin, Ciclosporin

Dabigatran: 110mg BD if

  • > 80 years
  • Concomitant tx with Amiodarone/Verapamil
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23
Q

Renal cut-offs for DOAC reduced doses

A

Apixaban = CrCl 15-30 - reduce dose

Rivaroxaban = CrCl 15-50 - reduce dose

Edoxaban = CrCl 15-50 - reduce dose

Dabigatran = CrCl 30-50 - reduce dose

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24
Q

Side effects of Heparin + LMWH

A
  • Hyperkalaemia - inhibits aldosterone secretion
  • Skin Reactions/Injection Side Reactions
  • Haemorrhages (Protamine)
  • Heparin-Induced Thrombocytopenia (30% reduction in platelet counts, less likely with LMWHs)
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25
Q

Dose adjustments of LMWH

A
  • Renal Impairment = CrCl 15-30

- Extremes of Body Weight (< 50, > 100)

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26
Q

Interactions with DOACs

A
  • Enzyme Inducers - reduced effectiveness
  • Enzyme Inhibitors - reduced doses may be needed
  • Apixaban, Dabigatran, Rivaroxaban - DON’T use SYSTEMIC azoles or HIV protease inhibitors
  • Dabigatran + Rivaroxaban - DON’T use dronaderone

Dabigatran

  • Verapamil + Amiodarone = dose reductions
  • C/I = inducers + inhibitors (other DOACs are cautioned)

Edoxaban + NSAIDs = C/I

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27
Q

Dose reductions of Dabigatran required with these concomitant drugs

A
  • Verapamil

- Amiodarone

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28
Q

Dose reductions of Edoxaban required with these concomitant drugs

A
  • Ciclosporin
  • Dronedarone
  • Erythromycin
  • Ketoconazole
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29
Q

Aspirin Side Effects + Caution

A
  • Bronchospasm - cautioned in asthma

- GI Bleeds/Ulceration - contraindicated in active disease, may need PPI protection

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30
Q

Clopidogrel Interactions

A

Clopidogrel is a pro-drug + needs to be metabolised in order to get the active form

Inhibitors of the CYP 450s:

  • Omeprazole
  • Ciprofloxacin
  • Erythromycin
  • Antifungals
  • SSRIs
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31
Q

Side Effects of Dipyridamole

A

Dipyridamole - alternative to Clopi/Aspirin

Causes vasodilation + tachycardia - so careful in some conditions

  • diarrhoea, nausea, vomiting
  • dizziness, headache, flushing
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32
Q

Stages of Hypertension

A

Stage 1: 140/90 to 160/100 = treat at risk patients
(< 60 yrs with a > 10% CVD risk, over 80s with BP of 150/90) + consider treatment in others at risk

Stage 2: 160/100 to 180/120 = treat all patients

Stage 3: >180/120 = severe, treat same day

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33
Q

Step-Wise Tx for Hypertension in < 55 years, not Afro-Carribbean and for Type 2 DM’s

A
  1. ACE/ARB
  2. ACE/ARB + CCB (OR a TZD-like if oedema or HF)
  3. ACE/ARB + CCB + TZD
  4. Add in Low-Dose Spiro OR Alpha-Blocker/B Blocker
34
Q

Step-Wise Tx for Hypertension in > 55 years, Afro-Carribbean

A
  1. CCB
  2. CCB + ACE/ARB (OR a TZD-like if oedema/HF)
  3. CCB + ACE/ARB + TZD
  4. Add in Low-Dose Spiro OR Alpha-Blocker/B Blocker
35
Q

Antihypertensive option for someone with Type 1 Diabetes?

A

ACE/ARB - to prevent micro/macrovascular complications

36
Q

Antihypertensive option for someone who is breastfeeding?

A

Non-Afro-Carribbean: Enalapril

Afro-Carribbean: Nifedipine/Amlodipine

Step Up: Labetalol/Atenolol

37
Q

Patient of Afro-Carribbean origin, preferred treatment between an ACE or ARB?

A

ARB

ACE - not as effective + higher risk of angiooedema

38
Q

What is the preferred thiazide to add in for treatment?

A

INDAPAMIDE - thiazide-like

rather than Bendro

39
Q

Blood Pressure Targets

A

(incl diabetes type 2s: )

  • Under 80s = 140/90
  • Over 80s = 150/90

135/80

  • Diabetes Type 1
  • Chronic Kidney Failure + CVD
  • Pregnancy

130/80
- Chronic Kidney Failure + Diabetes

40
Q

Who should receive primary prevention with a statin?

A
  • all those with QRISK > 10%
  • all those with chronic kidney disease
  • all those with diabetes type 1 > 40 years
  • all those who have had diabetes for 10+ years with other risk factors
  • over 85s to reduce risk of non-fatal MI
41
Q

Β Blockers licensed for HF

A
  • Bisoprolol
  • Carvedilol
  • Nebivolol (mild-moderate in > 70 years)
42
Q

Stepwise Tx for Heart Failure (Reduced Ejection Fraction)

A
  1. ACE/ARB + Β Blocker
  2. ACE/ARB + B Blocker + Aldosterone Antagonist (monitor K !! - hyperkalaemia)
  3. ACE/ARB + B Blocker + Aldosterone + Digoxin

Furosemide/Bumetanide - for SYMPTOMATIC relief
(alternative = thiazide)
–> this is the only treatment needed for preserved ejection fraction

43
Q

Tx for HF as a result of AF

A
  • Β Blocker + Digoxin + Anticoagulation
44
Q

Cholesterol Targets

A

Healthy Adult:

  • Total = < 5
  • LDL = < 3

High Risk:

  • Total = < 4
  • LDL = < 2

Treatment Target: high-intensity statin reduce LDL-cholesterol by 40%

45
Q

Statins Interactions

A
  • Statins + Ezetimibe/Fibrates = AVOID due to myopathy
  • Macrolides - stop taking until course completed
  • Enzyme Inhibitors
  • Grapefruit Juice
  • Amlodipine, Amiodarone, Azoles

Dose Reductions Required For:
SIMVASTATIN - 20mg maximum with
- Amlodipine, Diltiazem, Verapamil

ATORVASTATIN - 10mg maximum with Ciclosproin
ROSUVASTATIN - 20mg maximum with Clopidogrel

46
Q

Key Things About Statins (to learn)

A

Teratogenic - need protection during treatment + 1 month after, discontinue for 3 months before conceiving

LFTs - monitor before, 3 months + 12 months

Atorvastatin/Rosuvastatin = can be taken at any time of the day, the rest at NIGHT

Report Muscle Weakness/Pain - myopathy
Report SOB, Cough - interstitial lung disease

MHRA - Simvastatin 80mg = really high risk of myopathy only use in high risk patients, most doses need reducing due to concomitant meds (e.g. amlodipine)

47
Q

Intensity of Statins

A

HIGH:

  • Atorvastatin 80, 40, 20
  • Rosuvastatin 40, 20, 10
  • Simvastatin 80

MEDIUM:

  • Atorvastatin 10
  • Rosuvastatin 5
  • Simvastatin 20 + 40
  • Fluvastatin 80

LOW:

  • ALL Pravastatin
  • Simvastatin 10
  • Fluvastatin 40 + 20
48
Q

Stepwise Treatment for STABLE angina

A

Acute Attacks: always a GTN

1st Line: Β Blocker (/Rate-Limiting CCB - but only if no HF)
2nd Line: B Blocker + Normal CCB (never rate-limiting!)

Alternatives: nitrates, nicosrandil, ranolazine, ivabradine

49
Q

Secondary Prevention of ACS Meds

A

ACS BAG:

  • Aspirin 75mg Lifelong
  • Clopidogrel (/alt e.g. Prasugrel if PCI or Ticagrelor if low bleed risk)
  • Statin - Atorvastatin 80mg
  • Β Blocker (or can have rate-limiting CCB if no HF)
  • ACE Inhibitor
  • GTN Spray

(+ PPI for DAPT)

50
Q

Stepwise Tx of Acute Coronary Syndromes

A

Community: Aspirin 300mg STAT

STEMI (complETE occlusion)
- PCI or Fibrinolysis (Clot-Buster)

NSTEMI

  • Fondaparinux - then assess with GRACE score (6-month mortality - if above 3% then: )
  • PCI/Angiography
  • < 3% then conservative management
51
Q

Key Points of Nitrates

A

GTN:

  • if using MORE than 2 times a week then need some long-term prophylaxis (e.g. with a B Blocker)
  • side effects: hypotension/postural hypotension causing dizziness, weakness, palpitations, headaches, flushing, nausea + vomiting = so make sure the patient is SAT DOWN
  • wait 5 minutes between each dose + 3 doses = CALL 999
  • GTN tabs = expire 8 weeks after opening
  • SILDENAFIL etc is CONTRAINDICATED = both drugs cause marked vasodilation + hypotension
  • careful when using with other antihypertensives

Nitrates:

  • the ones with BD dosing - take dose after 8 hours not 12 to ensure a nitrate-free period
  • patches = leave them off for 8-12 hours overnight
  • AVOID abrupt withdrawal as worsens the angina on stopping
52
Q

Key Points of Other Vasodilators

A

Nicorandil - main thing = ULCERS !

  • GI ulceration - careful with other meds that cause this e.g. steroids, bisphosphonates, NSAIDs
  • MHRA warning = skin, mucosal + eye ulcers, stop immediately if these occur
  • side effects = HEADACHES, dizziness, flushing, nausea + vomiting

Ivabradine - LOW HEART RATE

  • CONTRAINDICATED if HR < 70 (on initiation), stop treatment if HR < 50
  • side effects: blurred vision (eye disorders), AF, QT prolongation, BRADYCARDIA

Ranolazine - prolongs QT

53
Q

What condition are people with Coeliac disease at risk of?

A

Osteoporosis due to malabsorption

54
Q

Abx to treat acute diverticulitis

A

1st Line: Co-Amoxiclav

Pen Allergy: Metronidazole + Trimethoprim/Cefalexin/Ciprofloxacin

55
Q

Management of Diverticular Disease

A

Symptomatic:
BULK - FORMING LAXATIVES to help with constipation

ANTISPASMODICS for abdominal cramps

56
Q

Which drugs increase the risk of diverticular perforation?

A

Opioids + NSAIDs

57
Q

Short Bowel Syndrome

A

shortened bowel due to a resection

nutritional deficiencies: fat-sol vitamins, B12, zinc, selenium, magnesium

diarrhoea = manage with rehydration therapy + loperamide at high doses

absorption of drug affected + EC/MR preparations are UNSUITABLE

58
Q

Anal Fissures

A

tear/ulcer in the lining of anal canal

  • acute < 6 weeks = just manage with bulk-forming laxative/osmotic
  • chronic > 6 weeks = GTN rectal ointment
59
Q

Pancreatin Insufficiency

A

due to pancreatic cancer, pancreatitis, CF, coeliac etc.

replace pancreatic enzymes - CREON to help with nutrients

side effects:
- irritation to the mouth + skin reactions = the product is an ENZYME so will start to break down products, GI effects + colonic damage

counselling:
- don’t mix with hot foods/drinks = inactivates the enzymes
- don’t hold in the mouth - irritation
- hypersensitivity when handling
- GR/EC - mix with slightly acidic foods/liquids

60
Q

Stomas

A

again, EC/MR preparations are UNSUITABLE

sorbitol found in liquids can have a laxative effect + increase stoma output

may need antidiarrhoeals (loperamide in high doses due to lack of enterohepatic circulation)

PPIs can be used to reduce stoma output

61
Q

Crohn’s disease Management

A

Acute Flare Ups:

  • 1 flare/year = IV Corticosteroids OR Budesonide
  • 2 flare ups or more/year = Azathioprine/Mercaptopurine AND Corticosteroids/Budesonide (or can try Methotrexate if TPMT deficient etc)

Remission:

  • Azathioprine/Mercaptopurine - for everyone
  • Methotrexate - only for those that had it to induce remission OR if purines not acceptable
62
Q

Ulcerative Colitis Management

A

generally, aminosalicylates, applied in a formulation depending on how far the inflammation goes up the colon
suppositories –> foams –> enemas –> oral

mild-moderate flare ups: 
non-extensive
- Topical Aminosalicylate for 4 weeks 
- Then PO Aminosalicylate for 4 weeks 
- Then Topical/Oral Steroids for 4-8 weeks 
extensive (up to the ascending colon) 
- Topical Aminosalicylate + High-Dose PO Aminosalicylate for 4 weeks 
- Then corticosteroid for 4-8 weeks

severe flare ups = LIFE-THREATENING

  • IV Steroids
  • IV Ciclosporin if not working after 72 hours

remission

  • just colon: rectal aminosalicylates with/without intermittent oral aminosalicylates
  • ascending + descending colon: low dose aminosalicylate
63
Q

What are the 4 aminosalicylates + class key points?

A

Sulfasalazine, Mesalazine/Balsalazide/Olsalazine:

side effects:

  • Blood Dyscrasias (stop immediately)
  • Nephrotoxic
  • Salicylate Hypersensivitiy - related to aspirin (caution in asthma)
  • GI discomfort, diarrhoea, N&V
  • Lupus-Like Syndrome

interactions:
- other drugs that suppress the immune system (Aza/Mercaptopurine)
- drugs that affect the kidneys
-

64
Q

Sulfasalazine specific side effects:

A
  • pancreatitis/hepatic failure or abnormalities (monthly monitoring for 3 months)
  • reversible decrease in sperm of men (oligospermia)
  • sulfa allergies
  • colours urine/contact lenses
  • causes low folate - need adequate supplementation in pregnancy

interactions:
- folate drugs - methotrexate, trimethoprim
- meds that affect the liver
- digoxin - decreases concentrations

monitoring:
- full blood counts - baseline and 3 months
- liver - monthly checks for first 3 months
- renal

65
Q

Mesalazine specific side effects:

A

90% of those intolerant to sulfasalazine can tolerate meslazine:
- headache most common

+ other aminosalicylate effects rarely

interactions - special coating so it can reach down to the colon so anything that changes the pH will change the release:

  • lactulose
  • PPIs
  • indigestion remedies
66
Q

IBS key points

A

advice;

  • limit fresh fruit to 3 portions per day
  • but increase soluble fibre (e.g. oats)
  • DON’T have insoluble fibre e.g. bran/resistant starches
  • reduce intake of caffeine/fizzy drinks
  • avoid sorbitol - diarrhoea
  • DON’T use lactulose as can cause bloating
67
Q

Faecal Impaction management

A

Hard Stools = Macrogol (high dose)

Soft Stools = Stimulant

then enemas for both if not working

68
Q

Constipation in Pregnancy

A

1st Line: Dietary
2nd Line: Bulk-Forming

avoid Senna near term - causes uterine contractions, unstable pregnancy

69
Q

Constipation in Children

A

1st Line: Macrogol + Diet/Behavioural
2nd Line: Stimulant
3rd Line: Lactulose/Docusate

Faecal Impaction

  • Macrogol escalating dose regimen
  • stimulant + osmotic add in if doesn’t help after 2 weeks
70
Q

Red Flags of Dyspepsia

A
  • over 55
  • unexplained weight loss
  • GI bleeding - malaria, haematemesis
  • recurrent vomiting
  • dysphagia
71
Q

Dyspepsia Management

A

first presentation;
1st Line: Anatacid/Alginate
2nd Line: PPI for 4 weeks max

then once investigated - use PPI at lowest effective dose

72
Q

Those high risk of peptic ulcer disease with NSAID use

A

those with a hx of peptic ulcer disease

OR - those with 2 risk factors:

  • over 65
  • high dose NSAID
  • other drugs that affect GI
  • serious co-morbidity
  • heavy smoker
  • excessive alcohol
  • prev ADR to NSAIDs
  • taking NSAIDs for prolonged amount of time
73
Q

GORD Management

A

uninvestigated:
1st Line: Antacid/Alginate for symptoms
2nd Line: PPI for 4 weeks

confirmed GORD:
1st Line: PPI for 4-8 weeks (/H2 antagonist if not working)

severe oesophagi’s
1st Line: PPI for 8 weeks

74
Q

Urea 13C Breath Test

A

for H Pylori

  • don’t perform within 2 weeks of PPI treatment
  • don’t perform within 4 weeks of Abx treatment

only re-test under specific circumstances following treatment
- take at least 4 weeks, but ideally 8 weeks after tx finishes

75
Q

H Pylori Eradication Treatment

A

TRIPLE THERAPY - all BD dosing for 7 days (1st + 2nd Line, then goes to 10 days under specialist)
- a PPI + Amoxicillin 1g + Clarithromycin 500mg/Metronidazole 400mg

OR - allergy
- a PPI + Clarithromycin 500mg + Metronidazole 400mg

PPI:

  • Lansoprazole 30mg BD
  • Omeprazole 20-40mg BD
  • Pantoprazole 40mg BD
  • Esomeprazole 20mg BD
76
Q

PPIs Key Points

A

MHRA Alert - SCLE, drug-induced sun-lesions + arthralgia, consider withdrawing and avoid exposure to sunlight

long-term side effects:

  • osteoporosis risk
  • increased risk of C diff infections
  • mask symptoms of gastric cancer
  • reduced absorption of nutrients
  • hypomagnesia
  • rebound secretion on stopping

key interactions:

  • clopidogrel + omeprazole/esomeprazole
  • phenytoin + omeprazole/esomeprazole - increased phenytoin
77
Q

Loperamide Key Points

A

MHRA: serious cardio events when used in large doses
MHRA: symptoms of overdose can be treated with naloxone

avoid if any sign of infective diarrhoea

max 16mg per day (usually 8 per box isn’t there)

OTC: for diarrhoea in OVER 12
OTC: for IBS in OVER 18

78
Q

H2 Antagonists

A

Rare Side Effects:

  • psychiatric reactions
  • hepatitis/cholestatic jaundice
  • bradycardia
  • leucopenia, thrombocytopenia, pancytopenia,
  • joint/muscle pain

Cimetidine - enzyme inhibitor (Warfarin, Theophylline, Phenytoin, Nifedipine)
Other Interactions - for all H2 Antagonists:
- Azole Antifungals - decreased absorption due to changes in pH

79
Q

Laxatives

A

Bulk-Forming - swells to increase faecal max

  • 72 hours onset
  • ensure adequate water otherwise may cause obstruction/impaction
  • hypersensitivity when handling

Osmotic - increases water
- Macrogol = 2-3 days
- Lactulose = 2 days - not for lactose intolerant
MHRA - macrogol, adding starch based thickeners counteracts and results in a thin liquid, fatal for dysphagia

Softeners

  • Oral = 1-2 days
  • PR = 20 minutes - don’t use in haemarrhoids/fissures

Stimulants - MHRA = prone to abuse

  • Senna = 8-12 hours, discolours urine
  • Bisacodyl = 6-12 hours
  • Sodium Picosulfate = 6-12 hours
80
Q

When to step up asthma treatment?

A
  • using salbutamol > 3x a week
  • symptomatic > 3 x a week
  • waking at night 1x a week
  • using > 1 salbutamol a month
    (SIGN - asthma attack in the last 2 years)
81
Q

Asthma Step-Wise Treatment

A

both NICE/SIGN

  • Salbutamol
  • Low-Dose ICS

then NICE add in Montelukast
but SIGN add in LABA (as MART if needed)

then NICE add in LABA
then SIGN add in Montelukast OR med dose ICS

then NICE change to MART regime
then SIGN add in high ICS or 4th drug

then NICE change to Med dose ICS then High dose then 4th drug

same for paediatrics but lower doses of ICS

82
Q

Acute Asthma

A

2-10 puffs of salbutamol via an inhaler every 10-20 minutes - ring an ambulance after 15-30 minutes

prednisolone course needed

  • Children = 3 days only
  • Adults = at least 5 days

Pre-Reg Exam (8 decks)

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