Respiratory

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  • Created by: AJ-A
  • Created on: 26-05-22 09:50
symptoms of asthma
coughing (especially at night), wheezing, chest tightness, shortness of breath
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Which relievers are used when required?
SABA - salbutamol/terbutaline
alt. SAMA (ipratropium bromide)
or if >12yrs theophylline / oral B2 agonist (bambuterol)
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Step up trmt if only using SABA and pt is...
-symptomatic and using inhaler >3 times / week
-night time symptoms at least once/week
-had asthma attack requiring steroid trmt in last 2 years
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If using more than one salbutamol inhaler in a month...
should have your asthma control reviewed
(referral)
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Pathway to treat ASTHMA
step 1 - Low dose ICS (OD then BD)
step 2 - Add LABA with low dose ICS
step 3 - stop LABA and increase ICS dose
- if beneficial but inadequate continue LABA and simply increase to medium-dose ICS
- if beneficial but inadequate trial LTRA, LAMA or SR theop
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Alternative to step 1 asthma trmt
LTRA, Theophylline, inhaled sodium cromoglycate / nedocromil
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Examples of ICS
Mometasone (OD or BD), Fluticasone (BD), Beclometasone (BD), Budesonide (BD), Ciclesonide (only OD)
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Examples of LABA
Formoterol (short onset, long action), Salmeterol (long onset, long action)
Brands - fostair, duoresp spiromax, symbicort
age >18
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Example of LAMA
Tiotoprium bromide
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Example of LTRA
Montelukast, Zafirlukast
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S/E of LABAs
Hand tremors, hyperglycaemia, hypokalemia, serious cardiovascular effects (including tachycardia)
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When is it recommended to use a large volume spacer?
when using High Dose ICS and for pts u15
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S/E of zafirlukast
report signs of liver toxicity; jaundice, nausea, vomiting, abdominal pain, itching
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signs of toxicity of theophylline
vomiting and GI effects, tachycardia, arrhythmias, convulsions, hypokalemia
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First line for Chronic Obstructive Pulmonary Disorder
SABA/SAMA
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Step up trmt for COPD
Offer LABA/LAMA (if LAMA stop SAMA)
Consider ICS as triple therapy in pts who have severe exacerbation or 2 moderate exacerbations in a year
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Examples of LABA
Olodaterol
Indaceterol
Vilanterol (anoro elipta)
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Examples of SAMA
Ipratropium bromide
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Examples of LAMA
Aclidinium (eklira genuair)
Glycopyrronium (seebri breezhaler)
Umeclidinium (Incruse Elipta)
Tiotropium (spiriva handihaler)
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which prophylactic antibiotic treatment is given for COPD
Azithromycin
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examples of non-sedating antihistamines
cetirizine
loratadine
fexofenadine
acrivastine
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Hydoxizine is a unique antihistamine and caution should be taken as it can cause
QT prolongation + torsades de point
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Adrenaline dose for children
-u6
-6-12
->12
u6 - 150mcg
6-12 300mcg
500mcg
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Angiodema is treated the same way as anaphylaxis which is
adrenaline (+oxygen)
Antihistamine
Corticosteroid
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how does carbocisteine help COPD
by reducing viscosity of cough sputum
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first line for croup (medical emergency) [1month -2 years]
dexamethasone oral solution
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Other cards in this set

Card 2

Front

Which relievers are used when required?

Back

SABA - salbutamol/terbutaline
alt. SAMA (ipratropium bromide)
or if >12yrs theophylline / oral B2 agonist (bambuterol)

Card 3

Front

Step up trmt if only using SABA and pt is...

Back

Preview of the front of card 3

Card 4

Front

If using more than one salbutamol inhaler in a month...

Back

Preview of the front of card 4

Card 5

Front

Pathway to treat ASTHMA

Back

Preview of the front of card 5
View more cards

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