Resp Factfiles

Question 1

theophylline indications

Answer 1

Chronic asthma
Reversible airway obstruction

Question 2

Theophylline Overdose symptoms

Answer 2

Tachycardia
Hyperglycemia
Agitation
Haematemesis
Vomiting

Question 3

What increases theophylline concentration

Answer 3

Macrolides
Cimetidine
Ciprofloxacin

Question 4

What decreases theophylline plasma concentrations

Answer 4

Decreases with St John wort
carbamazepine

Question 5

Doses of theophylline and smoking

Answer 5

Start smoking: Possible dose increase
Stop smoking: Possible dose decrease

Question 6

Therapeutic range of theophylline

Answer 6

10-20mg/L

Question 7

When to check plasma theophylline levels after starting

Answer 7

5 days

Question 8

When to check theophylline plasma levels after a dose change

Answer 8

3 days

Question 9

What electrolyte disturbance can theophylline cause

Answer 9

Hypokalaemia - with concomitant drugs

Question 10

Which drugs alongside theophylline increase hypokalaemia risk

Answer 10

Beta 2 agonists
Corticosteroids
Diuretics

Question 11

Acute exacerbation of COPD

Answer 11

Oral pred 30mg for 5 day (unable to carry out daily activities due to SOB)

Amox/ doxy/ clarithromcyin (if at high risk of complications, repeated abx or sputum change)

Question 12

Monitoring for children using ICS

Answer 12

Weight and height annually

Question 13

QVAR V CLENIL

Answer 13

QVAR has extra fine particles and is two times as potent

Question 14

DPI

Answer 14

Quick and deep

Question 15

pMDI

Answer 15

Slow and steady

Question 16

COPD

Answer 16

1) SABA/SAMA
2) if asthmatic features -> LABA+ ICS
If no asthmatic LABA+LAMA

3) LAMA+LABA+ICS
- One severe exacerbation requiring hospital
- Two moderate exacerbations within a year
- If symptoms are affecting QOL (switch back if no benefit)

Question 17

When starting prophylactic azithromycin what monitoring requirements are required

Answer 17

Baseline ECG needed to rule out prolonged QT and LFTs are required