Asthma

Question 1

What is the treatment for Mild or moderate asthma in adults?

Answer 1

Salbutamol pMDI

4-12 doses every 20 mins
- 4 breaths each dose

Question 2

What is the treatment for severe asthma in adults?

Answer 2

Salbutamol 10mg nebulised (5mL)
Ipratroprium bromide 500mcg nebulised (2mL)
-> repeat salbutamol 5mg (2.5mL) @ 5 mins
- no max

Dexamethasone 8mg oral/IV

Question 3

What is the asthma treatment in adults if there is an inadequate response to severe treatments?

Answer 3

Adrenaline 500mcg IM
repeat 500mg @ 5 min intervals
no max

If no response consult for IV adrenaline

Question 4

What is the adrenaline dose if non response to IM adrenaline or thunderstorm asthma?

Answer 4

consult clinician

20mcg @ 2 min intervals IV

Question 5

How do you draw up adrenaline for thunderstorm asthma?

Answer 5

1. draw up adrenaline 1mg/1ml into 10ml syringe
2. dilute with 9ml of saline making 100mcg/ml
3. discard 9ml and re-draw up 9ml saline making 10mcg/ml
4. administer 2 ml

Question 6

What is the treatment for mild to moderate asthma in paediatrics?

Answer 6

Salbutamol pMDI:
2-5 years old = 2-6 doses
Over 6 = 4 - 12 doses

Repeat 20 mins
4 breaths per dose

Question 7

What is the treatment for severe asthma in paeds

Answer 7

Nebulised salbutamol:
Small children (2-4) = 2.5mg (1.25mL)
Medium Children (5-11) = 2.5-5mg
- repeat 20 mins as required

Ipratroprium Bromide 250mcg (1mL) Nebulised

Question 8

WHat is the treatment for critical asthma in paeds?

Answer 8

Nebulised salbutamol 10mg (5mL)
- repeat 10mg @ 5 mins no max

Ipratropium Bromide 250mcg (1mL) nebulised

Dexamethasone 600mcg/kg oral
- Max 12mg

Adrenaline 10 mcg/kg IM

• repeat 5-10 mins as required
• max 30mcg/kg

Question 9

What symptoms defines mild/moderate asthma in paeds?

Answer 9

Normal CS
Some increased WOB
Tachycadia
Speaking in phrases/sentances

Question 10

What symptoms defines severe asthma in paeds?

Answer 10

Agitated/distressed
Marked increased WOB
Accessory muscle use/retraction
Tachycardia
speaking in words

Question 11

What symptoms defines critical asthma in paeds?

Answer 11

Altered conscious state
maximal WOB
marked tachycardia
unable to speak

Question 12

What are the contraindications for salbutamol

Answer 12

None

Question 13

What are the contras for Ipratropium bromide?

Answer 13

Hypersensitivity to atropine and its derivatives

Question 14

What are contraindications for Dexamethasone?

Answer 14

Hypersensitivity

Question 15

WHat are the contraindications for adreanline

Answer 15

hypovolaemic shock without adequate fluid replacement

Question 16

What are the precautions for salbutamol

Answer 16

Large doses of salbutamol have been reported to cause intracellular metabolic acidosis

Question 17

What are the side effects of salbutamol

Answer 17

sinus tachycardia

muscle tremor

Question 18

What are the precautions for Ipratropium bromide

Answer 18

• Glaucoma

- avoid contact with the eyes

Question 19

What are the side effects of Ipratropium bromide

Answer 19

• headache
• nausea
• dry mouth
• skin rash
• tachycardia
• palpitations
• acute angle closure glaucoma

Question 20

What are the precautions of dexamethasone

Answer 20

if its not clear or is contaminated discard it

Question 21

What are the side effects of dexamethasone

Answer 21

Nil

Question 22

What is the onset peak and duration for salbutamol neb

Answer 22

onset= 5-15 min
peak = n./a
duration = 15-50 mins

Question 23

What is the onset peak and duration for ipratropium bromide neb

Answer 23

onset= 3-5min
peak = 1.5-2hours
duration = 6 hours

Question 24

What is the onset peak and duration for dexamethasone IV

Answer 24

onset= 30-60min
peak = 2hours
duration = 36-72 hours