Respiratory SAHD.txt

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Author:
klq
ID:
119161
Filename:
Respiratory SAHD.txt
Updated:
2011-11-27 12:37:57
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Respiratory
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Respiratory SAHD
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  1. What device is used to deliver O2 at a fixed concentration?
    Venturi Mask
  2. What drug(s) does Seretide contain?
    Fluticasone and Salmeterol
  3. What drug(s) does Spiriva contain?
    Tiotropium Bromide
  4. What drug(s) does Ventolin contain?
    Salbutamol
  5. What drug(s) does Symbicort contain?
    budesonide and formoterol
  6. When delivering long-term oxygen therapy to stable patients, what is the appropriate pO2?
    pO2 < 7.3kPa
  7. When delivering long-term oxygen therapy to patients with conditions like nocturnal hypoxaemia, polycythaemia or cor pulmonale, what is the appropriate pO2?
    pO2 < 8kPa
  8. Name two short acting beta2 agonists
    Salbutamol; Terbutaline
  9. Name two long acting beta2 agonists
    Salmeterol; Formoterol
  10. Name a short-acting antimuscarinic
    Ipratropium
  11. Name a long-acting antimuscarinic
    Tiotropium
  12. Name three inhaled steroid treatments
    Beclomethasone, Fluticasone, Budesonide
  13. Name a Phosphodiesterase inhibitor and what (broadly) is its effect on the body?
    Theophylline- bronchodilator
  14. What are likely causative organisms in community acquired pneumonia?
    Gram-positive bacteria, mycoplasma, chlamydia, coxiella, common viruses (eg influenza)
  15. What are likely causative organisms in hospital acquired pneumonia?
    Gram negative enterobacteria, staph aureus, drug-resistant organisms
  16. List six common antibiotics used in gram-positive respiratory infections
    Penicillins: Amoxicillin,Co-amoxiclav, Piperacillin/tazobactam

    Macrolides: Erythromycin, Clarithromycin, Azithromycin
  17. List five common antibiotics used in gram-negative respiratory infections
    Quinolones: ciprofloxacin, moxifloxacin

    Aminoglycosides: Gentamycin, Tobramycin, Amikacin
  18. List one oral, and one type of nebulised antibiotic, used prophylactically to prevent respiratory infections
    Oral azithromycin, nebulised aminoglycosides
  19. 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.
  20. In COPD, what type(s) of drugs are used in initial management of SOB/exercise limitation?
    Inhaled SABA or short-acting antimuscarinics
  21. In COPD, what drug(s) can be used to manage exacerbations:
    (a) If FEV1 >50% ?
    (b) If FEV1 <50% ?
    (c) Regardless of FEV1 ?
    (a) LABA
    (b) SABA with ICS
    (c) Long-acting antimuscarinic (tiotropium)
  22. 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)

    O2:
    -deliver with care, and control, via Venturi mask
    -adjust by SaO2 not patient/relative/nurse distress
    -guide later by ABGs
    -NIV if needed
  23. Name a common causative organism in serious CAP and an effective antibiotic to treat it
    Strep pneumoniae and Penicillin
  24. 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
  25. Suggest an antibiotic with good gram-negative cover for nosocomial pneumoniae.
    By what route should it be administered?
    Tazocin (Pipericillin/Tazobactam) IV

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