Revision: COPD/ Asthma

Question 1

which cells are associated with asthma?

Answer 1

eosinophils

Question 2

an example of a SABA?

Answer 2

salbutamol

Question 3

an example of a LABA?

Answer 3

formoterol/ salmeterol

Question 4

an example of a SAMA?

Answer 4

Ipratropium

Question 5

an example of a LAMA?

Answer 5

Tiotropium

Question 6

acute asthma treatment?

Answer 6

• Oxygen (at least 60%- aim for Sp02 94-98%)
• Salbutamol (neb) (SABA)
• Hydrocortisone (IV) OR oral prednisolone (corticosteroid)
• Ipratropium (neb) (SAMA)
• Theophylline (oral) (methylxanthine)
• Magnesium sulphate (IV)
• An anesthetist (to intubate)

Question 7

which ILs in asthma?

Answer 7

4, 5, 13

Question 8

acute COPD hospital treatment?

Answer 8

• Ipratropium (nebulised, high dose) (SAMA)
• Salbutamol (nebulised, high dose) (SABA)
• Oxygen (target spO2 88-92%)
• Antibiotic: amoxicillin (/doxycycline)
• Prednisolone/ Physio (intermediate corticosteroid)

Question 9

long term asthma treatment steps?

Answer 9

1. SABA + ICS
2. SABA + ICS + LABA/LAMA
   
   1. If no response - stop LABA and increase ICS
   2. If some response - continue LABA and increase ICS
3. Add LTRA/Theo
4. Add oral steroid and anti-IgE/anti-IL5/anti-IL4⍺

Question 10

if there is no response to LABA in asthma what happens to ICS?

Answer 10

increase it

Question 11

what do you do if there is some response to LABA and ICS?

Answer 11

continue LABA
increase ICS

Question 12

what is the triad for asthma?

Answer 12

reversible airway obstruction
T2 airway inflammation
airway hyperresponsiveness

Question 13

COPD treatment if well enough to treat at home?

Answer 13

• Oral prednisolone
• Increase SABA/SAMA
• Antibiotics if evidence of infection (amox/ doxy)

Question 14

genetic predisposition to COPD is related to deficiency in what?

Answer 14

alpha-1 antitrypsin deficiency
failure to breakdown neutrophil elastase