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Prof Pharmacy I > Respiratory Conditions > Flashcards

Respiratory Conditions Flashcards

1
Q

What are the strains of the flu? (Explain briefly)

A

Type A = most virulent, causes pandemics

Type B = only found in humans, milder localised fly

Both A + B = annual flu outbreak

Type C = less common, mild symptoms spread by cough/sneeze droplets

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2
Q

How is flu spread?

A

droplet transmission

hand-to-hand, shared objects = less common

Onset of symptoms = usually sudden

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3
Q

Flu signs and symptoms

A

Symptom onset = 1-3 days after infection
Symptoms = sudden high fever, chills, sweating, headache (severe, photosensitivity), generalised joint/muscle pain, weakness, fatigue

Initial resp symptoms = scratchy throat, runny nose, dry cough
Later resp symptoms = persistent, raspy, productive cough

Acute symptoms = subside 2-3 days, fever up to 5 days

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4
Q

What are notable differences between cold and flu?

A

Flu = sudden onset, systemic illness, prominent headache, body aches, prolonged weakness/fatigue, fever

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5
Q

Discuss the aims of cold and flu treatment

A

Reduce symptoms

Help patient function and feel better

Rest, adequate fluid intake

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6
Q

Discuss the use of cough and cold medicine in children

A

Cough and cold medicine in children is restricted

Children <2 = S4 only
2-6 yrs = not to be given
6-11 yrs = only on advice of doctor, pharmacist, nurse practitioner

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7
Q

What oral decongestants are used for cold/flu/covid treatment?

A

pseudoephedrine
phenylephrine

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8
Q

Considerations for oral decongestants

A

C/I = severe/uncontrolled HTN
ADRs = CNS stim, tremor

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9
Q

What nasal decongestants are used for cold/flu/covid treatment?

A

oxymetazoline
xylometazoline
phenylephrine
tramazoline

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10
Q

Considerations for nasal decongestants

A

short term use = rebound congestions

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11
Q

What sedating antihistamines are used for cold/flu/covid treatment?

A

Promethazine
Chlorpheniramine

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12
Q

Considerations for sedating antihistamines

A

Some evidence for runny nose

ADRs = antichol effects, sedation, drowsiness

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13
Q

What cough mixtures are used for cold/flu/covid treatment?

A

Expectorants (productive) = senega, ammonium salts, gauifenesin

Mucolytics (productive cough) = bromhexine, acetylcysteine

Cough suppressants (dry cough) = codeine, dexamethorphan, dihydrocodeine, diphenhydramine

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14
Q

What is a 1st line antiviral medication for flu?

A

Neuraminidase inhibitors (S4) = Zanamivir (diskhaler), oseltamivir (Capsule/powder)

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15
Q

When should antivirals be used to treat flu?

A

Within 48 hrs of symptom onset, not recommended for healthy people

shortens duration by 1 day, may reduce complications

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16
Q

Who gets free flu vaccines?

A

Children <6 months - < 5 yrs

First Nation’s People <6 months

pregnant women, people ages >65 yrs

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17
Q

What age groups can pharmacists administer flu and covid vaccines to?

A

Covid = >5 yrs
Flu = >6 months

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18
Q

Common COVID signs and symptoms

A

Fever, dry cough, fatigue

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19
Q

Less common COVID symptoms

A

loss of smell/tase, nasal congestion, sore throat, headache, muscle/joint pain

GI disturbances, chills, dizziness

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20
Q

What medications (other than vax) treat COVID?

A

molnupiravir

nirmatrelvir + ritonavir

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21
Q

Discuss viral tonsillitis

A

Limited tonsillar exudate

occurs at any age, may be associated with cough

lasts 3-7 days

22
Q

Discuss bacterial (strep) tonsillitis

A

Common bacterial cause, common <15 years of age

Tonsillar exudate = white/yellow patches

swollen tender glands, fever >38C, cough is rare

23
Q

How is acute tonsillitis treated?

A

Throat swab used to diagnose

Antibiotics = severe cases or when at risk of rheumatic fever

24
Q

What antibiotics can be used to treat acute tonsillitis?

A

phenoxymethylpenicillin = 10 days

cephalexin for 10 days

Azithromycin for 5 days

25
Q

What is rheumatic fever?

A

Develops 2-4 wks after strep

Fever, joint pain, involuntary muscle movement

Risk factor = malnutrition, poverty

26
Q

How is recurrent tonsillitis treated?

A

tonsillectomy = modest reduction in number of sore throats

beneficial for patients with = breathing difficulties, freq ear infections associated with tonsillitis

27
Q

What is glandular fever?

A

Another cause of sore throat, A.K.A. Epstein-Barr virus (‘kissing disease)

symptoms - pharyngitis, fever, cervical lumphadenopathy, fatigue, malaise

28
Q

How is epstein barr/glandular fever treated?

A

Supportive management = avoid strenuous activity, rest, pain relievers

No vaccine, no exclusion period

antibiotics not indicated

corticosteroids have role in severe cases

29
Q

What drug cause drug-induced sore throats? What are symptoms?

A

Drugs that cause agranulocytosis = captopril, carbimazole, cytotoxic, clozapine) > immediate referral

Occur in 3 months of treatment

Symptoms/Signs = sore throat, fever, rash, fatigue, mouth ulcers, reduce granulocytes

30
Q

Non-pharm treatments of sore throat

A

Drink warm drinks
scuk lozenges
sucking on ice

31
Q

What are some pharm treatments of sore throats?

A

Anti-inflammatories = flurbiprofen (>12 yrs old), benzydamine (all patients, >6 yrs)

32
Q

What antiseptic agents are used for sore throats?

A

Most sore throats are viral

Chlorhexidine rinse, povidone iodine (virus, bact, fungi)

33
Q

What local anaesthetics can be used for sore throats?

A

Benzocaine (children >6), lignocaine (short duration)

34
Q

What is rhinosinusitis?

A

complication of common cold in 2% people, nasal secretions stagnate and become infected

Acute rhinosinusitis (=/> 2 lasting less than 3 months) = nasal blockage/nasal discharge, facial pain, reduction or loss of smell

35
Q

What are some avoidable asthma triggers?

A

Cigarette smoke, allergens (pets, moulds, dust mites, pollen)

Airborne/environmental irritants (cold/dry air, smoke, perfumes, home reno material)

Medicines = aspirin, NSAIDs, bee products

36
Q

What are some unavoidable asthma triggers?

A

Exercise, laughter, resp tract infection, certain medicines (aspirin, anticholinergics, beta blockers)

Comorbid medical conditions = allergic rhinitis, nasal polyps, obesity, GORD

physiological/psychological change = extreme emotion, hormonal changes, pregnancy, sexual activity

37
Q

What are some asthma signs and symptoms?

A

dyspnoea, chest tightness, wheezing, cough sputum production

reduced airflow/inc airway resistance, hyperinflation of lungs, bronchial hyperresponsiveness

38
Q

What are the three asthma management plans?

A

Asthma management plan, asthma action plan, asthma first aid plan

39
Q

What are the 6 steps to asthma management plan?

A

Assess asthma severity

achieve best lung function

maintain best lung function by avoiding triggers

maintain best lung function with optimal medication

develop individualised, written action plan

educate and review regularly

40
Q

What is an asthma flare up?

A

Inc wheezing, chest tightness, cough, SOB

waking at night with asthma symptoms

use reliever again within 3 hrs

41
Q

What is an asthma emergency?

A

symptoms worsen quickly
severe SOB, cant talk comfortably, lips look blue

42
Q

What does an asthma action plan show?

A

allows carer to take early action

Give clear instruction on what to do in response to worsening asthma symptoms

Instructs on how to adjust meds in response to symptoms

when/how to get medical care (inc. emergency)

43
Q

What is the acronym for asthma emergency?

A

4x4x4

Do not rely on wheeze or lack thereof

44
Q

How is asthma first aid different in children?

A

Lower dose

Children 1-5 yrs = 6 puffs
children 6-11 yrs = 12 puffs (same as adult)

Prednisolone = 1mg/kg daily (max 50mg) 3-5 days

45
Q

Briefly discuss pressurised metered dose inhalers

A

Requires breath coordination, most generic type

can attach a spacer

46
Q

Briefly discuss actuated pressurised metered dose inhalers (thicker pMDI w/ lever)

A

relies on patient to breathe in

limited amount of medicines available for this time

47
Q

Briefly discuss dry powder inhalers (multi dose)

A

requires inspiratory breath

can’t be used with spacer

has no taste

48
Q

Briefly discuss dry powder (capsule) inhalers

A

May be difficult to hold

require big breath in

cant attach a spacer

49
Q

Briefly discuss mist inhaler

A

More drug gets to lung

does not require breath/hand coordination

50
Q

What are some considerations for asthma devices?

A

Patient age, manual dexterity (Weak hands, arthritis)

ability to form good seal around mouthpiece (cognitive impairment, facial weakness)

language barrier = difficult to provide instructions, consider interpreter

multiple inhaler use = avoid confusion and use same type of device

Prof Pharmacy I (11 decks)

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