QuestionSBA
QuestionChoice
Tiotropium is a long-acting muscarinic agonist predominantly used in the maintenance treatment of COPD and occassionally in severe but stable asthma. It is not recommended in the acute setting.
10005279
d
Inhaled tiotropium
QuestionChoice
IV aminophylline may be considered following consultation with senior medical staff for patients who fail to respond and are requiring senior critical care support. They should be treated in an appropriate ITU/HDU setting if requiring IV aminophylline.
10005278
c
IV Aminophylline
QuestionChoice
This is a treatment commonly reserved for life-threatening asthma or unresponsive severe asthma. BTS notes that the evidence base is mixed for this treatment.
10005277
b
IV Magnesium Sulphate
QuestionChoice
This is a classic presentation of an acute attack of asthma. According to the BTS classification, this acute asthma is classified as severe. Initial management should consist of oxygen to ensure saturations of 94-98%, nebulised salbutamol and ipratropium and a five-day course of oral prednisolone.
10005276
a
Nebulised salbutamol and ipratropium
QuestionChoice
Umeclidinium is a long-acting muscarinic antagonist used in the maintenance treatment of COPD or in severe (but stable) asthma. It is not recommended in the acute setting.
10005280
e
Inhaled umeclidinium
Concept
Chapter
2693
3725
Asthma
Topic
132
Respiratory
13602
An 18-year-old female, with a past medical history significant for asthma, presents to the emergency department. She complains of a two-hour history of worsening dyspnoea, wheeze and a cough that is not responding to her blue salbutamol inhaler. On examination her airway is patent. Her oxygen saturations are 90% on air, her respiratory rate is 26 and she is unable to speak in full sentences. She is tachycardic with a pulse rate of 112 and her peak expiratory flow rate is 45% of her normal.

Which of the following is the best next step in the management of this patient?
a