respiratory system Flashcards
(60 cards)
symptoms of COPD
breathlessness
cough
wheezing
sputum production
frequent LRTI
what is a low FEV1/FVC
lower than 0.7
forced expiratory vol in 1 second
forced vital capacity
what is CURB-65
score to assess severity of CAP
What does CURB-65 stand for
Confusion
Urea (greater than 7mmol/L)
Respiratory rate (greater than 30)
Blood pressure : 90/60 or lower
65 yrs or older
first choice antibiotic for CAP low severity
First choice: if severity is low (CURB 65 of 0 or 1)
Amoxicillin 500mg x3 a day for 5 days
if amoxicillin not suitable then or allergic to penicillin then alternatives are:
1) doxycycline 200mg first day, 100 mg once a day for 4 days (5 day course)
2) clarithromycin 500mg x2 a day for 5 days
3) Erythromycin (in pregnancy): 500mg x4 a day for 5 days.
first choice antibiotic for CAP moderate severity
1) Amoxicillin: 500mg x3 a day for 5 days
2) clarithromycin: 500mg x2 a day for 5 days
3) erythromycin: 500mg x4 a day for 5 days
CURB-65: 1 or 2
First choice antibiotic for high severity CAP
CURB-65: 3/4 or higher
1) Co-amoxiclav: 500/125mg x 3 day orally or 1.2g x3 a day IV for 5 days.
first choice antibiotic treatment for HAP
low severity
Co-amoxiclav: 500/125mg x 3 a day for 5 days
doxycycline if allergic
or
co-trimoxazole: 960mg x 2 a day for 5 days.
first choice IV antibiotic if severity is high for HAP
1) piracillin with tazobactam: 4.5 g x 3 a day
2) Ceftazidime: 2g x 3 day
3) ceftriaxone: 2 g once a day
4) cefuroxime: 750mg x 3 a day
cough suppressant example
Dextromethorphan
expectorant
example
Guaifenesin
helps treat dry cough with mucus
Decongestants
example
pseudoephedrine
phenylephrine
example of a SABA bronchodilator to treat asthma in kids ?
albuterol
pair with inhaled corticosteroid
e.g. fluticasone
to reduce inflammation.
Examples of non sedating antihistamines and advantages/disadvantages and side effects
1) Loratadine
2) Cetirizine
3) Fexofenadine
Advantages: less likely to cross BBB = less drowsy
- longer duration of action
- reduced cognitive impairment.
Disadvantages: mild sedation in high dose of cetirizine.
side effects: headache, dry mouth, dizziness, fatigue, GI irritation.
sedating antihistamines (examples, advantages, disadvantages, side effects)
1) Diphenhydramine
2) chlorpheniramine
3) promethazine
advantages:
- Effective for treating allergy symptoms
disadvantages: - drowsiness
- not ideal for day time use due to sedative effects
side effects: drowsiness, dizziness, headache, dry mouth, blurred vision, constipation, urinary retention.
- long term use in elderly = cognitive impairment.
nasal corticosteroids (examples, advantages, disadvantages, side effects)
1) Fluticasone
2) Mometasone
3) Budesonide
Advantages:
- reducing inflammation, nasal congestion, sneezing
- minimal systemic absorption
Disadvantages:
- requires frequent usage for greater effect
- not immediate effect
side effects: nasal irritation/dryness/burning, nose bleeds, sore throat, increased intraocular pressure.
nasal antihistamines (examples, advantages, disadvantages, side effects)
examples: Azelastine, olopatadine
Advantages:
- fast acting, directly targets symptoms
- fewer systemic side effects
disadvantages:
- nasal irritation or bitter taste
- requires proper administration technique (spray)
side effects: nasal dryness, headache, drowsiness, mild irritation.
mast cell stabilisers (examples, advantages, disadvantages, side effects)
Cromolyn sodium, nedocromil
advantages:
- prevents allergic reaction by stabilising mast cells
- non drowsy
disadvantages:
- must be used regularly
- less effective for short term symptoms
side effects: nasal irritation, throat dryness, coughing, sneezing.
ocular antihistamines (examples, advantages, disadvantages, side effects)
olopatadine, ketotifen
advantages:
- targets eye symptoms directly
- fast acting and effective for seasonal allergies
disadvantages:
- requires proper administration
side effects: eye irritation, eye dryness, headache, bitter taste.
3 types of allergy tests
1) skin prick test
2) blood test (Specifically IgE test)
3) patch test
3 drug groups that trigger asthma
1) NSAIDs
2) B-blocker
3) ACE inhibitor
How do NSAIDs trigger asthma
moves arachidonic acid pathway towards increased production of leukotrienes, causing bronchoconstriction and air way inflammation.
How do beta blockers trigger asthma
blocks B2 adrenergic receptors on smooth muscle of airways, causing bronchoconstriction and airway inflammation.
How do ACE inhibitors trigger asthma
increased levels of bradykinin, may lead to airway irritation, coughing, exacerbating asthma.
