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What device is used to deliver O2 at a fixed concentration?
What drug(s) does Seretide contain?
Fluticasone and Salmeterol
What drug(s) does Spiriva contain?
What drug(s) does Ventolin contain?
What drug(s) does Symbicort contain?
budesonide and formoterol
When delivering long-term oxygen therapy to stable patients, what is the appropriate pO2?
pO2 < 7.3kPa
When delivering long-term oxygen therapy to patients with conditions like nocturnal hypoxaemia, polycythaemia or cor pulmonale, what is the appropriate pO2?
pO2 < 8kPa
Name two short acting beta2 agonists
Name two long acting beta2 agonists
Name a short-acting antimuscarinic
Name a long-acting antimuscarinic
Name three inhaled steroid treatments
Beclomethasone, Fluticasone, Budesonide
Name a Phosphodiesterase inhibitor and what (broadly) is its effect on the body?
What are likely causative organisms in community acquired pneumonia?
Gram-positive bacteria, mycoplasma, chlamydia, coxiella, common viruses (eg influenza)
What are likely causative organisms in hospital acquired pneumonia?
Gram negative enterobacteria, staph aureus, drug-resistant organisms
List six common antibiotics used in gram-positive respiratory infections
Penicillins: Amoxicillin,Co-amoxiclav, Piperacillin/tazobactam
Macrolides: Erythromycin, Clarithromycin, Azithromycin
List five common antibiotics used in gram-negative respiratory infections
Quinolones: ciprofloxacin, moxifloxacin
Aminoglycosides: Gentamycin, Tobramycin, Amikacin
List one oral, and one type of nebulised antibiotic, used prophylactically to prevent respiratory infections
Oral azithromycin, nebulised aminoglycosides
Outline the five steps in adult asthma management (based on BTS guidelines)
1. SABA PRN
2. SABA + ICS (200-800mcg/day)
3. SABA + ICS + LABA (if responsive, reduce ICS, if unresponsive cease LABA and increase ICS)
4. Increase ICS, add leukotriene receptor antagonist or theophylline or oral beta2 agonist.
5. Daily oral steroids at min dose for control, high dose ICS, consider other Rx, refer.
In COPD, what type(s) of drugs are used in initial management of SOB/exercise limitation?
Inhaled SABA or short-acting antimuscarinics
In COPD, what drug(s) can be used to manage exacerbations:
(a) If FEV1 >50% ?
(b) If FEV1 <50% ?
(c) Regardless of FEV1 ?
(b) SABA with ICS
(c) Long-acting antimuscarinic (tiotropium)
Outline the management of COPD exacerbations
↑ frequency of inhaled treatment (often nebulised)
Steroids for all (30 mg od 7-14/7)
Antibiotics if sputum purulent (oral usually)
-deliver with care, and control, via Venturi mask
-adjust by SaO2 not patient/relative/nurse distress
-guide later by ABGs
-NIV if needed
Name a common causative organism in serious CAP and an effective antibiotic to treat it
Strep pneumoniae and Penicillin
What is a key difference in the structure of organisms which cause atypical pneumonia? And what are the implications of this for Abx therapy?
They lack a cell wall.
Penicillins won't work, so use a macrolide
Suggest an antibiotic with good gram-negative cover for nosocomial pneumoniae.
By what route should it be administered?
Tazocin (Pipericillin/Tazobactam) IV