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Flashcards in 6 Resp Deck (19):
1

Laba should be added in before increasing ICS above .....

400 micrograms of beclometasone equivalent

2

Compare asthma and COPD

ASTHMA
Variable
Dry cough, worse at night
Any age
More response to ICS
COPD
Fixed/progressive
Chronic productive coughs
Mainly older smokers

3

Complete asthma control is

No daytime symptoms /night time awakening
No need for rescue medication
No asthma attacks
No limitations of activity
Normal lung function
Minimal side effects

4

What is normal lung function defined as in terms of the aim of asthma therapy

Fev1 > 80%

5

Risks of Rx oxygen in COPD

Fire
COPD pt normally have high co2, low O2. In non-COPD patients the drive to breath is high O2 but in COPD there is always high O2 therefore the drive becomes low O2. They will therefore stop breathing with lots of oxygen.

6

How to administer oxygen in COPD

Venteuri face mask - no more than 28 %

7

What O2 levels to aim for in COPD

SaO2 of 88-92%,[4] (compared with 94-98% for most acutely ill patients

8

What mask to deliver oxygen in for asthma

Reservoir - which is about 60%

9

How does long term oxygen therapy work in COPD?

Tricks the heart in to believing there is lots of oxygen around so works less hard.
For those who are hypoxic at rest.

10

SMART TRIAL

Poorly controlled asthma at step three or above?
Use just ICS and laba as reliever and preventer. See BNF.

11

Triple therapy is

COPD - Laba, ICS and lama.
Associated with reduction in admissions and exacerbations and quality of life but not over all mortality

12

Simple

Stop smoking
•Inhaler technique
•Monitoring
•Pharmacotherapy
•Lifestyle
•Education

13

Current and previous smoking reduces effectiveness of .....

ICS
So higher doses may be needed

14

Two types of resp fail

Type 1 O2 6.5kPa

Normal O2 =11-13 kPa Normal CO2 = 4.7 – 6 kPa

15

Problem with high levels of co2

Acidosis - usually up you up the resp rate to get rid of co2 but if you can't up it enough

16

In asthma use nebulise with what gas

Oxygen nebuliser gas

17

Monitoring during asthma attack

O2 levels
Resp rate
Potential mg concentration if you gave him some

18

Monitoring if you give him aminophylline IV in acute asthma

Amino levels, gas levels, gas stats, nausea and vom, potassium levels

19

How is the severity of COPD assessed?

Mild fev1 > 80%
Intermediate 50-79
Severe 30-49
V severe