Order cardiopulmonary resuscitation decisions
Which of the following statements is
most correct about deprescribing in an
A. deprescribing is a relatively new concept
B. it is relatively easy to implement ‘patientbased approaches’ to deprescribing
C. prescriber behaviours rarely affect
D. prescribing medicines of questionable
benefit is infrequent in nursing homes
E. prescriptions of preventative drugs
tend to increase on admission to a
An 82-year-old man who has end-stage
chronic obstructive pulmonary disease
comes to the respiratory clinic for review.
He is currently managed with tiotropium, a high-dose fluticasone/salmeterol
inhaler, oral theophylline and home oxygen. Despite this, he is constantly short
of breath. He is unable to walk more than
a few yards. Examination confirms features of severe emphysema with a hyperexpanded chest, a respiratory rate of 25
breaths/minute at rest and bilateral poor
air entry with wheeze. Oxygen saturation is 91% on 2 litres of oxygen. Arterial
pa(O2) on two litres of oxygen is 8.9 kPa,
and pa(CO2) is 7.8 kPa. Which of the following is the most appropriate next step
to manage his breathlessness?
B. increased inspired oxygen
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