Allergic brionchipulmonary aspergillosis 

• brownishsputum, history of asthma, consolidation on upper zone of lungs 

AE asthma 

• start regular 4-6 puffs SABA and SAMA ( salbutamol and ipratiopium ) every 6 hourly + oral prednisone for 5 days 40mg 

• then change to PRN when no longer wheezy 

Severe asthma 

may consider adrenaline IM or IV magnesium 

weaned down to ICS + LABA 

AE COPD 

• start regular 4-6 puffs SABA and SAMA ( salbutamol and ipratiopium ) every 6 hourly + oral prednisone for 5 days 40mg 

• then change to PRN when no longer wheezy 

• LAMA + LABA combination - eg ANOVO 

Inhalers 

Pressured meter @ SABA 

Short acting beta 2 agonist - salbutamol / ventolin 100mcg 

Short acting muscuranic antagonist ---> ipratiopium / atovent 20mcg 

SABA + SAMA --> duolin 100/ 20 

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ICS 

Pulmicort - Corticosteroid ( turbohaler ) 

Flixotide - Accuhaler and Aerosal inhaler 

Beclomethasone 

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ICS + LABA 

Seretide - flutacasone + salmetrol 

fluticasone + vilanterol = breo elipta 

Symbicort - budesonide + formetrol 

LAMA - Spiriva 

COPD 

chronic bronchitis- x ray increased bronchiopulmonary markings 

emphysema : destruction of spaces distal to terminal bronchioles - x ray : inflated lungs, elonged heart 

final stage : cor pulmonale 

asthma - reversible with bronchodilaters 

PEV improves more than 15% or 200ml