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Respiratory > Respiratory Exam 1 - CYSTIC FIBROSIS > Flashcards

Respiratory Exam 1 - CYSTIC FIBROSIS Flashcards

(60 cards)

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1
Q

Aerosolized Antibiotics

A

Activity against Pseudomonas aeuroginsoa

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2
Q

Tobramycin Inhaled Solution (TOBI)

A

Aerosolized Antibiotic

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3
Q

Tobramycin Inhaled Solution (TOBI) - SPECTRUM

A

Gm(-) spectrum

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4
Q

Tobramycin Inhaled Solution (TOBI) - DOSING

A

> 6yo: 300mg Q12H
(QD in renal impairment)

Takes 15-20min to administer

28 days on, 28 days off

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5
Q

Tobramycin Inhaled Solution (TOBI) - AEs

A

Bronchospasm
Hoarseness
Pregnancy Category D

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6
Q

Aztreonam Inhaled Solution (Cayston)

A

Aerosolized Antibiotic

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7
Q

Aztreonam Inhaled Solution (Cayston) - DOSING

A

> 7yo: mix 1 vial of medication with 1 ampule of saline and add to ALTERA nebulizer handset

75mg TID (at least 4h between doses)

2-3min to administer

28 days on, 28 days off

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8
Q

Aztreonam Inhaled Solution (Cayston) - AEs

A 
Bronchospasm
Sore throat
Nasal congestion 
Fever
Pregnancy Category B
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9
Q

Colistimethate (Colistin)

A

Aerosolized Antibiotic

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10
Q

Colistimethate (Colistin) - DOSING

A

75-150mg BID

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11
Q

Colistimethate (Colistin) - AEs

A

Bronchospasm:

Use Albuterol after reconstitution to decrease

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12
Q

Mucolytics

A

Decrease viscosity of pulmonary secretions

Increase clearance of sputum

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13
Q

Dornase alfa (Pulmozyme)

A

Mucolytic

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14
Q

Dornase alfa (Pulmozyme) - MOA

A

Presence of DNA produces viscous mucus
-Selectively cleaves DNA & decreases mucus viscosity
Increase airflow and decrease risk of infection

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15
Q

Dornase alfa (Pulmozyme) - DOSING

A

2.5mg QD via nebulizer

Not approved in children <40)

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16
Q

Dornase alfa (Pulmozyme) - CONSIDERATIONS

A

Improvement in lung function in 8 days
-Increases adherence
Preserves lung function

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17
Q

Hypertonic Saline

A

Mucolytic

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18
Q

Hypertonic Saline - MOA

A

7% saline solution

Increases volume of fluid on epithelial lining of the airway to maintain normal ciliary flow and increase sputum expectoration

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19
Q

Hypertonic Saline - AEs

A

Bronchospasm

-Pretreatment with albuterol

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20
Q

Inhaled Corticosteroids

A

Anti-Inflammatory Agent

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21
Q

Inhaled Corticosteroids - INDICATIONS

A

Reserved for patients with reactive airways (asthma)

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22
Q

Oral Corticosteroids

A

Anti-Inflammatory Agent

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23
Q

Oral Corticosteroids - INDICATIONS

A

Long term:
Benefit lost shortly following DC

Short term:
Used in pts with aspergillus colonization
Helpful in acute exacerbations

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24
Q

Oral NSAIDS (Ibuprofen)

A

Anti-Inflammatory Agent

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25
Oral NSAIDS (Ibuprofen) - INDICATIONS
Benefit not seen immediately Shows slowed rate of pulmonary decline Does not improve lung function
26
Oral NSAIDS (Ibuprofen) - DOSING
20-30mg/kg BID
27
Azithromycin
Anti-Inflammatory Agent
28
Azithromycin - INDICATIONS
Decreases sputum production | Preserves lung function & decreases pulmonary exacerbations
29
B2-Adrenergic Receptor Agonists
Bronchodilators
30
SABA (Albuterol) - INDICATIONS
Used in combination with airway clearance to stimulate mucociliary clearance Used in combination with other inhaled therapies to prevent bronchospasm
31
LABA (Salmeterol)
Benefit for pts with recurrent wheeze or dyspnea
32
Inhaled Anticholinergic Agents (Impratropium)
Bronchodilators
33
Inhaled Anticholinergic Agents (Impratropium) - INDICATIONS
Act to decrease bronchospasm
34
Ivacaftor (Kalydeco)
CF Transmembrane Conductance Regulator Potentiator
35
Ivacaftor (Kalydeco) - MOA
Potentiates epithelial cell Cl- ion transport of defective G551D mutant cell-surface CFTR protein Improves regulation of salt and water absorption and secretion in various tissues Improves lung function
36
Chest Physical Therapy (CPT)
The traditional form Percussion & Postural drainage Takes about 30min
36
Chest Physical Therapy (CPT)
The traditional form Percussion & Postural drainage Takes about 30min
37
CPT - Percussion
Chest is clapped to dislodge mucus Done in various positions
38
CPT - Postural drainage
Pt gets into different positions Allows gravity to assist with mucus drainage
39
Oscillating Positive Expiratory Pressure (PEP)
Vibrates small and large airways Pt blows into device multiple times Pt coughs or huffs Repeat multiple times
40
High Frequency Chest Compression (HFCC)
Most commonly used technique Inflatable vest that uses external oscillation Every 5min pt stops machine and coughs
41
Sweat Cl- concentration <39mmol/L
CF unlikely
42
Sweat Cl- concentration 40-59mmol/L
CF possible
43
Sweat Cl- concentration >60mmol/L
CF diagnosis
44
Mutation of CF gene
Dysfunctional CFTR protein
45
Dysfunctional CFTR protein leads to
Decreased Cl- secretion Increased sodium reabsorption Altered viscosity of fluid secreted by exocrine gland
46
Early pathogens of CF
***Pseudomonas Staph. Aureus Non-typical H. Flu
47
CFF Guideline Recommendations - tobramycin for mild disease | FEV1 70-89%
Recommend the chronic use of inhaled tobramycin to reduce exacerbations - >/=6yo
48
CFF Guideline Recommendations - tobramycin for moderate to severe disease FEV1 <69%
Strongly recommend the chronic use of inhaled tobramycin to improve lung function & reduce exacerbations - >/=6yo
49
CFF Guideline Recommendations - Other antibiotics
Not recommended
50
CFF Guideline Recommendations - Dornase Alfa for mild disease FEV1 70-89%
Recommend chronic use to improve lung function & reduce exacerbations - >/=6yo
51
CFF Guideline Recommendations - Dornase Alfa for moderate-severe disease FEV1 <69%
Strongly recommend chronic use to improve lung function & reduce exacerbations - >/=6yo
52
CFF Guideline Recommendations - hypertonic saline
Recommend chronic use to improve lung function & reduce exacerbations - >/=6yo
53
CFF Guideline Recommendations - inhaled corticosteroids
Not recommended
54
CFF Guideline Recommendations - oral corticosteroids
Not recommended in children Insufficient evidence in adults
55
CFF Guideline Recommendations - NSAIDS
>/=6yo with FEV1 >60% recommends chronic use of ibuprofen to slow the loss of lung function
56
CFF Guideline Recommendations - azithromycin
Recommend chronic use to improve lung function & reduce exacerbations - >/=6yo
57
CFF Guideline Recommendations - leukotriene modifiers
Insufficient evidence
58
CFF Guideline Recommendations - B2-agonists
Recommend chronic use to improve lung function - >/=6yo
59
CFF Guideline Recommendations - anticholinergic agents
Insufficient evidence

Respiratory (4 decks)

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