V/Q matching, ABGs, Resp pharmacology, Inhalation & O2 therapy, and Sputum Flashcards
(126 cards)
1
Q
What is the primary function of corticosteroids in respiratory therapy?
A
Reduce airway inflammation and mucus production
2
Q
Which conditions are corticosteroids commonly used to treat?
A
Asthma and COPD
3
Q
Name the common inhaled corticosteroids.
A
Beclomethasone (becotide), Fluitcasone (Flixotide), Budesonide (Plumicort), Ciclesonide (Alvesco)
4
Q
Why should patients rinse their mouths after using inhaled corticosteroids?
A
To prevent oral infections (candidiasis)
5
Q
What is a major long-term side effect of systemic corticosteroids?
A
Osteoporosis
6
Q
What does the inflammatory reaction in airways trigger?
A
Brochospams, oedema, mucus hypersecretion
7
Q
How often are corticosteriods administered to patients?
A
2x a day
8
Q
How are corticosteriods administered?
A
Via tablets/inhaler/nebuliser in conjunction with long acting bronchodilators
9
Q
What are the common side-effects of corticosteriods?
A
Hoarseness & oral candidiasis
10
Q
What are the side-effects of inhaled corticosteriods?
A
Cataracts, skin bruising & osteoporosis (in high doses)
11
Q
What are the side-effects of systemic corticosteriods?
A
Osteoporosis, diabetes, hyperparathyroidism, muscle dysfunction & adrenal insufficiency (if overused)
12
Q
What is meant by “Corticosteroids don?t alter the course of the disease”?
A
It doesn?t eliminate/clear the source of the disease; it simply masks the sympyoms
13
Q
What drugs are used to facilitate airway bronchodilation?
A
Beta-2 agonist bronchodilators, Anticholinergic bronchodilators, Xanthines
14
Q
How are ?2 drugs administered?
A
Via an inhaler/nebuliser
15
Q
Other than bronchodilation, what’s another function of Beta-2 agonist bronchodilators?
A
Help to stabilize mast cell activity BUT pt may develop tolerance to drug & mast cell activity, therefore B-2 agonists will still relieve smooth muscle contraction but not combat mast cell activity
16
Q
How long does it take beta-2 agonistic bronchodilators to activate (what’s their onset time)?
A
7 minutes
17
Q
How long does beta-2 agonists provide symptomatic relief for?
A
4-8 hours
18
Q
What class of drugs stimulates ?2 receptors in bronchial smooth muscle?
A
Beta-2 agonists
19
Q
Name a short-acting beta-2 agonist.
A
Salbutamol (Others incl: fenoterol, terbutaline)
20
Q
Name a long-acting beta-2 agonist.
A
Salmeterol (Others incl: eformoterol, indacaterol)
21
Q
What are the common side effects of beta-2 agonists?
A
Tremor, tachycardia & agitation
22
Q
What is the primary function of anticholinergic bronchodilators?
A
Block acetylcholine to prevent airway narrowing
23
Q
What is the onset time for anticholinergic bronchodilators?
A
30-45 minutes
24
Q
Name a common anticholinergic bronchodilator.
A
Ipratropium bromide
25
What is a common side effect of anticholinergics that affects secretion clearance?
Dry mouth
26
What class of drugs includes Theophylline and Aminophylline?
Xanthines
27
What is a major side effect of xanthines that affects the stomach?
Gastric ulcers
28
What is a cardiovascular side effect of xanthines?
Cardiac arrhythmias
29
How are Xanthines administered?
Via IV/tablets
30
What are the functions of Xanthines?
Bronchodilate, decreases inflammation, boost immune system, improve gas exchange & lung function
31
What are the long-term side-effects of Xanthines?
Gastric ulcer formation & insomnia
32
What are the immediate side-effects of Xanthines?
Headache, nausea and vomiting, cardiac arrhythmias & tachycardia
33
Which class of drugs helps clear thick mucus from the airways?
Mucolytics
34
What type of saline is commonly used to induce sputum in cystic fibrosis patients?
Hypertonic saline
35
What mucolytic is commonly used in cystic fibrosis patients once daily?
Dornase alpha
36
What side effect can hypertonic saline cause in sensitive patients?
Bronchospasm
37
Which mucolytic may cause GI bleeding over time?
Carbocisteine
38
What is a common use of normal saline in respiratory therapy?
Humidifying the airways and assisting secretion clearance
39
True or False? Normal saline thins viscous secrettions.
False. It simply enhances clearance of viscous secretions BUT doesn't thin it out
40
How are mucolytics administered?
Via nebuliser
41
What are the implications for physio with regards to mucolytics?
Hypertonic saline can ? bronchospasm in pts prone to bronchospasm & Carbocisteine may cause GI bleeding over time
42
What are the side effects of normal saline?
There are none
43
How do corticosteroids affect muscle function with long-term use?
Can cause muscle dysfunction
44
What condition can long-term corticosteroid use contribute to besides osteoporosis?
Diabetes
45
Which class of bronchodilators has both short-acting and long-acting variants?
Beta-2 agonists
46
What is the peak effect time of short-acting beta-2 agonists?
20 minutes
47
What is the primary way anticholinergic bronchodilators are administered?
Inhaler or nebulizer
48
How do xanthines improve gas exchange?
By bronchodilating and reducing inflammation
49
Which xanthine drug is administered via IV or tablets?
Theophylline
50
What should be monitored in physiotherapy patients using bronchodilators?
Heart rate, tremors, and secretion clearance
51
Which drug combination includes corticosteroids and long-acting bronchodilators?
Symbicort or Seretide
52
What is a common side effect of inhaled corticosteroids?
Oral candidiasis (thrush)
53
How should inhaled corticosteroids be administered to reduce side effects?
With a spacer and mouth rinsing
54
What class of drugs is often used for acute asthma attacks?
Short-acting beta-2 agonists (SABAs)
55
Which respiratory drug class has a risk of developing tolerance with frequent use?
Beta-2 agonists
56
What is the function of mast cell stabilizers?
Prevent release of histamine and inflammatory mediators
57
How do systemic corticosteroids differ from inhaled corticosteroids?
Systemic corticosteroids have more systemic side effects and are used for severe cases
58
What is a key concern with long-term use of oral corticosteroids?
Adrenal suppression and withdrawal symptoms
59
Which drug is used as a rescue inhaler for asthma attacks?
Salbutamol (Ventolin)
60
61
What is the primary function of a nebuliser?
Converts liquid medication into aerosol particles for inhalation
62
When are nebulisers used instead of MDIs?
When simpler inhalers cannot deliver the drug effectively OR the drug can't be administered in any other way
63
What is the typical duration of nebuliser treatment?
10-15 minutes
64
What is the particle size produced by a nebuliser?
Less than 5æm
65
Describe the mechanism behind how neubisers work
Nebuliser converts solution into aerosol particles which are suspended in a stream of gas
66
Name two types of nebulisers
Jet nebulisers and Ultrasonic nebulisers
67
How does a jet nebuliser work?
Uses compressed air/oxygen to create aerosol mist
68
What is the driving gas flow rate for a jet nebuliser?
5-6 L/min
69
How does an ultrasonic nebuliser generate aerosol?
Uses high-frequency sound waves
70
What factor determines particle size in an ultrasonic nebuliser?
The frequency of crystal oscillation
71
Which type of nebuliser produces a higher gas output?
Ultrasonic nebuliser
72
What is the standard drug volume delivered by all nebulisers?
4 ml
73
Name four types of drugs administered via nebulisers
Mucolytics, bronchodilators, corticosteroids, antibiotics
74
How should a nebuliser be cleaned after use?
Washed and dried thoroughly
75
Why should nebulisers be serviced regularly?
To prevent malfunction and ensure proper drug delivery
76
What must be carried when traveling with a portable nebuliser?
An international adaptor
77
What is the first step when using an MDI?
Shake the inhaler and hold it upright
78
Why should a patient sit upright when using an MDI?
To allow proper lung expansion and drug delivery
79
Why is it important to exhale fully before inhaling from an MDI?
To maximize lung capacity for drug intake
80
When should the canister be pressed in an MDI?
Just after starting to inhale
81
How long should a patient hold their breath after inhaling an MDI dose?
10 seconds
82
Why should patients wait one minute between MDI puffs?
To allow the canister to warm up and improve drug delivery
83
What should be done to an MDI canister in cold weather before use?
Pre-warmed in a pocket
84
What device improves MDI drug delivery and reduces side effects?
Spacer device
85
What is the main function of a spacer device?
Acts as a chamber between inhaler and patient to improve drug delivery
86
How do spacers help reduce side effects of steroid inhalers?
Large particles drop out in the chamber, reducing throat irritation
87
How does a spacer improve inhaler drug absorption?
Slows aerosol movement, reducing drug loss in the throat
88
Why do spacers help patients who struggle with inhaler coordination?
They allow for better timing between inhalation and drug release
89
When are spacers especially useful?
During acute asthma episodes when high doses are needed
90
Why should all children using steroid inhalers use a spacer?
To reduce side effects and improve medication delivery
91
What is one key benefit of ultrasonic nebulisers over jet nebulisers?
They produce higher gas output
92
What type of medication is commonly used in nebulisers for cystic fibrosis patients?
Mucolytics
93
How do nebulisers help patients with severe airway obstruction?
Deliver medication directly to the lungs in aerosol form
94
What should be done before exhaling when using an MDI?
Hold the breath for 10 seconds
95
What is a key precaution to take when using a nebuliser?
Ensure it is cleaned properly to prevent bacterial contamination
96
Why do MDIs require shaking before use?
To mix the drug evenly within the canister
97
What component in an ultrasonic nebuliser produces vibrations?
Piezoelectric crystal
98
Why should an MDI mouthpiece be sealed with lips?
To ensure all medication is inhaled without leakage
99
What is a common mistake patients make with MDIs?
Inhaling too quickly instead of slowly and deeply
100
Why do MDIs have a cooling effect when used repeatedly?
The propellant cools down with frequent use
101
What should be done if an MDI is not used for a long time?
Prime it by releasing a test spray
102
What happens if a nebuliser is not serviced regularly?
Reduced drug efficiency due to blockages
103
What type of inhaler requires less patient coordination?
Dry powder inhaler (DPI)
104
What is the function of a propellant in an MDI?
Helps disperse the drug as an aerosol
105
Describe the process, from start to end, on how to correctly use a metered dose inhaler (MDI)
Shake inhaler, hold it upright & remove cap. Sit upright. Exhale fully. Seal lips around mouthpiece. Breathe in through mouth, pressing the top of the canister just after initiation of breath, inhale slowly & deeply. Hold the breath for 10 sec before exhaling. If more than one dose is prescribed, wait 1 min between puffs > each puff cools the canister and ? its efficiency. In cold weather, the canister should be pre-warmed in the pocket.
106
List the advantages of a using a spacer device
Large particles drop out in the chamber, thus reducing local sideeffects of steroids. Aerosol momentum is slowed so that less is lost by action at the back of the throat. Less coordination is required to deliver the aerosol to the airways. High doses of medication can be delivered during an acute episode
107
What is auscultation?
Process of listening to & interpreting the sounds produced within the thorax
## Footnote
Auscultation is a key diagnostic tool in clinical settings.
108
What are the components of a stethoscope?
* Bell
* Diaphragm
* Tubing
* 2 earpieces
## Footnote
Each component serves a specific purpose in auscultation.
109
What is the function of the diaphragm on a stethoscope?
Listen to breath sounds
## Footnote
The diaphragm is designed for high-frequency sounds.
110
What is the function of the bell on a stethoscope?
Listen to heart sounds (low frequency)
## Footnote
The bell is effective for detecting lower frequency sounds.
111
In what position should a patient be during auscultation?
Seated/side-lying position
## Footnote
This position helps enhance the quality of the sounds heard.
112
What should a patient do to reduce turbulence during auscultation?
Breathe in & out through mouth
## Footnote
This technique minimizes noise from nasal breathing.
113
What is the normal breath sound?
Generated by turbulent airflow in trachea & large airways
## Footnote
Normal breath sounds are typically louder in the apices and softer in lower lobes.
114
What characterizes bronchial breath sounds?
Normal tracheal sounds heard in lung periphery over consolidated lung areas
## Footnote
These sounds are present throughout inspiration & expiration.
115
What does diminished breath sound indicate?
* ↓ in initial sound generation
* Globally diminished: pain or muscle weakness
* Locally diminished: obstruction of bronchus or localized fluid/air
## Footnote
Diminished sounds can be a sign of various underlying issues.
116
What are crackles?
Clicking sounds heard during inspiration due to opening of previously closed alveoli & small airways
## Footnote
They can be coarse (early inspiratory) or fine (late inspiratory).
117
What is the difference between coarse and fine crackles?
* Coarse: early inspiratory crackles -> sputum retention
* Fine: late inspiratory crackles -> pulmonary oedema or pulmonary fibrosis
## Footnote
The type of crackle can indicate different conditions.
118
What are wheezes?
Whistling/musical sound produced by turbulent airflow through narrowed airways
## Footnote
Wheezes can be classified as monophonic or polyphonic.
119
When are wheezes first heard?
On expiration
## Footnote
In cases of severe bronchospasm, wheezes may be heard during both inspiration and expiration.
120
What does pleural rub sound like?
Rubbing sound with each breath, like boots crunching on snow
## Footnote
It occurs when pleural surfaces are roughened by inflammation, infection, or neoplasm.
121
What is stridor?
Wheezing sound in upper airways, louder on inspiration than expiration
## Footnote
Stridor indicates upper airway obstruction.
122
What are adventitious sounds?
Any out of the ordinary breath sounds
## Footnote
Adventitious sounds can indicate various respiratory conditions.
123
What are vesicular breath sounds?
Normal breath sounds
## Footnote
Vesicular sounds are typically soft and low-pitched.
124
What does a high-pitched wheeze when aucultating indicate?
Near total obstruction of airways
125
What does a low-pitched wheeze when auscultating indicate?
Sputum retention
126
When auscultating, when will you hear wheezing upon inhalation AND exhalation?
When a pt has svere bronchospasms
