Respiratory Therapeutics

Question 1

What is asthma

Answer 1

Rapid onset of bronchospasm

Question 2

What are the symptoms of asthma

Answer 2

Wheeze
Shortness of breath
Cough
Chest tightness

Question 3

When can asthma show late onset

Answer 3

Occupational asthma
Asthma/copd overlap syndrome
Heart failure

Question 4

What are the features that increase the risk for asthma suspicion

Answer 4

Symptoms
Worse at night, with exercise or in cold air
History of atopic disorder e.g allergic rhinitis
Family history of asthma

Question 5

What are the triggers for asthma

Answer 5

• allergies: dust mites, pollens
• drugs: aspirin and beta blockers
• occupational exposure
• environmental: cold air, emotion, exercise

Question 6

What is the mananagement of asthma in particular inflammation by

Answer 6

Steroids

Question 7

What is the management of inflammatory mediators by

Answer 7

Leukotriene antagonist

Question 8

What si the management of bronchospasm by

Answer 8

Beta 2 agonist

Question 9

In asthma treatment what are the aims

Answer 9

To relieve:
Day time symptoms 
Exacerabations
No limitaions of daily activity 
Normal lung function

Question 10

What is the first line treatment for asthma

Answer 10

Beta 2 agonist

Question 11

Name examples of beta 2 agonist

Answer 11

Salbutamol

Question 12

What is the role of beta 2 agonist

Answer 12

Bronchodilator

Question 13

What are the adverse effects of beta 2 agonist

Answer 13

Tremor
Tachycardia
Decrease pottassium

Question 14

When do we need to use the stepwise approach in asthma

Answer 14

When people need to use thir inhalers frequently

Question 15

What is the second line management

Answer 15

Inhaled corticosteroids

Question 16

Name an example of an inhaled corticosteroid

Answer 16

Beclemetasone
Fluticasone
Budesonide

Question 17

When are inhaled corticosteroids added into the management

Answer 17

Exacerbation in the last 2 years
Use of beta 2 agonist more than twice a week
Symptoms occur at least one night per week

Question 18

What are the adverse effects of inhaled corticosteroids

Answer 18

Sore throat
Oral candiasis
Osteoporosis
Growth supression in children

Question 19

What is the 3rd line management in the stepwise approach

Answer 19

Long acting beta 2 agonist

Question 20

Name an example of a long acting beta 2 agonist

Answer 20

Salmeterol

Formoterol

Question 21

What is the 4th line management of astham in the stepwise approach

Answer 21

Leukotriene receptor antagonist

Question 22

Name an example of a leukotrine receptor antagonist

Answer 22

Montelukast

Question 23

What are the side effects of leukotrine receptor antagonist

Answer 23

Hypersensitivity

GI upsets

Question 24

What is the 5th line intervention in the stepwise apprach

Answer 24

Xanthine derivative

Question 25

What is a problem with xanthine derivatives

Answer 25

They have a narrow therapeutic index and can cause cardiac arrhythmia and seizures

Question 26

What is the 6th line management of asthma in the stepwise approach

Answer 26

Long acting antimuscarinic agents

Question 27

Name an example of a antimuscarinic agent

Answer 27

Tiotropium

Question 28

What can the reasons for poor response of asthma be

Answer 28

Poor compliance Wrong use of inhaler technique Presence of triggers Wrong diagnosis

Question 29

What is an acute severe asthma

Answer 29

When someone with asthma gets: - sudden onset of SOB and chest tightness - cant complete full sentences - HR more than 110 bpm - RR more than 25 - PEFR less than 50% predicted

Question 30

What is life threatening asthma

Answer 30

``` PEFR less than 33% preducited Sats less than 92% Cyanosis Hypotension Siltent chest Tachycardia ``` (CHEST)

Question 31

How do we treat and astham attach

Answer 31

Mnemonic: O SHIT ME - oxygen - salbutamol - hydrocortisone - ipratropoium - therophylline - mangesium sulfate - escalate

Question 32

What is COPD

Answer 32

Chronic obstructive pulmonary disease

Question 33

What are the symptoms of COPD

Answer 33

Couhg and sputum | Increasing and often chronic breathlessness

Question 34

What is the management of COPD

Answer 34

1. Inhaled bronchodilator: - beta 2 agonists: short acting or long acting beta 2 agonist - antimuscarinic: short acting or long acting 2. Inhaled corticosteroids 3. Oral bronchodilators e.g theophylline

Question 35

Name a short acting antimuscarinic

Answer 35

Ipratropium

Question 36

Name a long acting antimuscarinic

Answer 36

Tiotropium

Question 37

What are the other management of COPD

Answer 37

``` Antibitoics if needed Vaccination Mucolytics for chornic productive cough Treat heart failure with diuretci Oxygen thereapy for respiratory failure Smokin cessation ```

Question 38

How do we give oxygen in COPD exacerbation

Answer 38

Venturi mask

Question 39

What are the mothods of smoking cessation

Answer 39

Nicotine replaement therapy Bupropion tablet Varenicline

Question 40

What are the methods in delivering drugs to the lungs directly

Answer 40

Inhalers Spacer devices Nebulisers

Question 41

What oxygen should be given in a venturi mask for COPD patients

Answer 41

24%

Question 42

What is the management of COPD exacerbation

Answer 42

O SHIT - oxygen- venturi mask - salbutamol - hydrocortisone - ipratropium - theophylline Antibiotics Chest physiotherapy