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PA- AP > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Indications of Beta 2 agonist

A

Asthma - SABA uses to relive breathlessness, LABA used to trat chronic asthma when ICS isn’t enough but given in combination with an ICS

COPD - SABA for breathless, LABA second line therapy

Hyperkalaemia — helps to lowers potassium levels

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2
Q

Contraindications for beta 2 agonist

A

LABA ONLY if on ICS

Caution for CVS patients

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3
Q

Pt ed for beta 2 agonist

A

Treats symptoms not disease, seek med advice if using inhaler frequently

Make they are clear on how and when to use

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4
Q

Side effects for beta 2 agonist (5)

A

Tachycardia

Palpitation

anxiety

tremor

LABA-muscle cramps

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5
Q

Monitoring for beta 2 agonist

A

Peak flow

potassium levels

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6
Q

Key interaction for beta 2 agonist

A

Beta blockers may reduce effectiveness of B2agonist

Codominant use of b2 agonist with theophylline and corticosteroid can lead to hypokalaemia

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7
Q

MOA for beta 2 agonist

A

β2-receptors are found in smooth muscle of the bronchi, gut, uterus and blood vessels.

Stimulation of this G protein-coupled receptor activates a signalling cascade that leads to smooth muscle relaxation. This improves airflow in constricted airways, reducing the symptoms of breathlessness.

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8
Q

2 SABA medication name

A

salbutamol
terbutaline

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9
Q

2 LABA medication name

A

salmeterol
formoterol

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10
Q

Indication for antimuscarinic

A

COPD
Asthma

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11
Q

Contraindication for Anti-muscarinic (3)

A

caution in patients susceptible to angle closure glaucoma, arrythmia or urinary retention

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12
Q

Pt ed for anti-muscarinic

A

Treats symptoms not the disease

Clear on inhaler technique and side effects and wash mouth after use or advice to chew gum or suck sweet

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13
Q

Side effects for anti-muscarinic

A

Irritation of respiratory tract

GI disturbance

Blurred vision and headache

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14
Q

Monitoring for anti-muscarinic

A

check if it helped with symptoms and peak flow, check side effect and check inhaler technique

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15
Q

Key interaction for anti-muscarinic

A

Not usually a problem due to low systemic absorption

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16
Q

name of a LAMA

A

tiotropium

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17
Q

name of a SAMA

A

ipratropium

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18
Q

indication for ICS

A

COPD
Asthma

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19
Q

Contraindication for ICS (2)

A

caution in COPD patients with a ▴history of pneumonia and in ▴children, where there is potential for growth suppression

20
Q

Pt ed for ics

A

offering to dampen down inflammation in the lung

advice to rinse mouth

check inhaler technique

21
Q

side effect for ics

A

oral candidiasis

hoarse voice

increase risk of pneumonia in COPD

22
Q

Monitoring for ics

A

check severity through symptoms and peak flow

review after 3-6 months of therapy should be undertaken to alter management

23
Q

Key interaction for ics

A

none clinically significant

24
Q

MOA for ICS

A

Corticosteroids pass through the plasma membrane and interact with receptors in the cytoplasm. The activated receptor then passes into the nucleus to modify the transcription of a large number of genes.

Pro-inflammatory interleukins, cytokines and chemokines are downregulated, while anti-inflammatory proteins are upregulated.

In the airways, this reduces mucosal inflammation, widens the airways and reduces mucus secretion. This improves symptoms and reduces exacerbations in asthma and COPD.

25
Q

indication for oxygen

A

acute hypoxemia

pneumothorax

CO poisoning

26
Q

Contraindication for oxygen

A

patients with chronic type 2 respiratory failure e.g COPD

27
Q

Pt ed in oxygen

A

Mask and cannula need to be kept

28
Q

side effect for oxygen

A

Dry throat

29
Q

Monitoring for oxygen

A

Frequent spO2

Arterial blood gas monitoring

30
Q

indications for antihistamine

A

First line for allergies

Pruritus and urticaria

adjunctive treatment in anaphylaxis

nausea and vomiting

31
Q

Contraindications for antihistamine

A

avoid sedating anti histamine in severe liver disease

32
Q

Pt ed for antihistamine

A

cetirizine and loratadine - no side effects

Chlorphenamine - may make you feel sleepy

33
Q

Side effect for antihistamine

A

sedation (first gen antihistamine)

34
Q

Monitoring for antihistamine

A

clinical assessment for allergic symptoms and enquire about side effects

35
Q

indication for montelukast

A

add on therapy for asthma (adults)

allergic rhinitis

36
Q

Contraindication for montelukast

A

only prescribed if asthma is incompletely controlled with ics

37
Q

Pt education for montelukast

A

advice to report side effects or worsening symptoms

38
Q

Side effect for montelukast

A

Headache

abdo pain

hyperactivity

39
Q

Monitoring for montelukast

A

efficacy measured by symptom diary and peak flow

40
Q

indication for mucolytic (acetylcysteine)

A

paracetamol poisoning
reduce resp secretion

41
Q

Side effect for mucolytic (acetylcysteine)

A

bronchospasm

diarrhoea

fever

headache

hypotension

42
Q

Patient education for mucolytic (acetylcysteine)

A

explain that the aim of treatment is to loosen secretions and help them
clear their sputum. Advise that treatment is additional to other
measures to improve sputum clearance, such as maintaining hydration
and doing regular chest clearance exercises.

43
Q

Monitoring for mucolytic (acetylcysteine)

A

monitor
efficacy of oral carbocisteine or acetylcysteine by enquiry about
frequency of cough and sputum production. Stop treatment if there is
no improvement in symptoms; if unacceptable side effects develop; or
if sputum production is no longer a problem.

44
Q

Indication for theophylline

A

Bronchodilator

45
Q

Contraindication for theophylline

A
  • HF
  • Viral infection
  • smoking and alcohol
  • Fever
46
Q

Side effects for theophylline

A
  • hyperuricemia
  • seizures
  • sleep disorders
  • Gi upset
  • Palpitation
47
Q

Key interaction for theophylline

A
  • quinolone
  • diltiazem
  • carbamazepine

PA- AP (11 decks)

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