Therapeutics Of Asthma & COPD

Question 0

Step 1 asthma management

Answer 0

B2 agonist

Eg Salbutamol

Question 1

Oral steroid side effects

Answer 1

Osteoporosis

Growth retardation in children

Question 2

Step 2 asthma management

Answer 2

Add inhaled steroid

Beclomtasone

200-800 mcg/day

Usually start at 400 - appropriate to disease severity

Question 3

Step 3 asthma management

Answer 3

Add inhaled long- acting B2 agonist (LABA) -eg Salmeterol

If inadequate try Leukotreine rec antagonists - eg Montekulast

SR theophyline

Question 4

Step 4 asthma management

Answer 4

Increase inhaled steroid up to 200 micrograms/day

Addition of 4th drug:
Leukotreine receptor antagonists
SR theophyline
B2 agonist tablet

Question 5

Inhaled steroid side effects

Answer 5

Dry/sore throat

Thrush

Question 6

Step 5 asthma management

Answer 6

Daily oral steroids (lowest possible dose)

Maintain high dose of inhales steroids

Question 7

Types of inhalers

Answer 7

Metered dose

Dry powder inhalers

Nebulisers

Question 8

What do nebulisers usually deliver?

Answer 8

Short acting B2 agonists

Short-acting antimuscarinics

Can be use to deliver high doses

Question 9

What’s a concern with patients taking a nebuliser home?

Answer 9

No point coming to hospital
May present really late
Beyond rescuing

Question 10

Acute asthma attack management

Answer 10

SABA
Steroids
O2
IV Magnesium
IV Salbutamol 
IV Aminophyline

Question 11

COPD symptoms

Answer 11

Exertional breathlessness
Chronic cough
Regular sputum production
Resp failure
Cot pulmonale

Abnormal BMI
Anxiety
Smoker
>35

Question 12

Define airflow obstruction

Answer 12

⬇️ FEV1

⬇️ ratio

Question 13

Initial COPD management

Answer 13

Quit smoking
Bronchodilator use
…

Question 14

Type 2 respiratory failure

Answer 14

⬆️O2

⬇️ CO2

Question 15

Problems with intubation/ ventilating COPD patients?

Answer 15

Really hard to get them off the ventilator!