Final year

Respiratory Therapeutics

Respiratory drug therapy and assessment in UK practice, for final-year medical students preparing for finals and the Prescribing Safety Assessment, final-year pharmacy students and foundation doctors. It covers stepwise asthma management, inhaler technique, acute severe asthma in adults and children, COPD inhaled therapy and infective exacerbations, controlled oxygen and type 2 respiratory failure, and respiratory examination, chest radiographs and bronchiolitis.

3 modules · 21 lessons 4 h EN

What you will be able to do

Take a structured respiratory history and perform a systematic respiratory examination, then present the findings concisely and link them to a working diagnosis.
Select an inhaler device for a patient with asthma or COPD, justify the choice, and demonstrate correct technique, including spacer use in adults and children.
Construct stepwise treatment plans for chronic asthma and COPD using current British National Formulary doses, explaining where practice varies by region or formulary.
Assess and begin immediate treatment of acute severe asthma in an adult or child, covering oxygen, inhaled and systemic bronchodilators and corticosteroid therapy, and identify when to escalate.
Prescribe controlled oxygen with target saturations for a patient at risk of type 2 respiratory failure and interpret serial arterial blood gases to detect rising carbon dioxide.
Write complete, safe prescriptions for an infective exacerbation of COPD and check them against prescribing safety rules before signing.
Interpret a chest radiograph for pneumothorax and describe the clinical and radiographic features of a pleural effusion.
Recognise the severity of bronchiolitis in an infant and outline supportive management and referral criteria.

About this course

Respiratory Therapeutics is a practical course on drug therapy and assessment for common respiratory conditions. It is written for final-year medical and pharmacy students and foundation doctors preparing for finals and the Prescribing Safety Assessment. Teaching is set in UK practice, with British National Formulary dosing and NICE-style guidance. Guidance and formularies differ between regions and institutions; where practice varies, the course says so rather than presenting one approach as universal.

Module 1: Asthma

The first module covers the stepwise management of chronic asthma, the distinction between preventer and reliever therapy, and the devices used to deliver inhaled drugs. You will work through inhaler technique for pressurised metered-dose inhalers, dry powder inhalers and spacers, including common errors and how to correct them.

Stepwise management of chronic asthma, including when to step up and step down.
Preventer versus reliever therapy: inhaled corticosteroids, long-acting beta₂-agonists and leukotriene receptor antagonists.
Inhaler devices and technique, with practical assessment of technique.
Acute severe asthma in adults and children: severity assessment, oxygen, nebulised salbutamol and ipratropium, systemic corticosteroids such as prednisolone, and escalation.

Module 2: COPD and respiratory failure

The second module moves to chronic obstructive pulmonary disease. It covers long-acting bronchodilators and inhaled corticosteroids, and the autonomic pharmacology that explains how these drugs work. You will review treatment, consider when to escalate or de-escalate, and manage infective exacerbations.

Long-acting beta₂-agonists and long-acting muscarinic antagonists in COPD.
Inhaled corticosteroids: benefits, risks and place in therapy.
Autonomic pharmacology: beta₂ receptors, muscarinic receptors and the drugs that act on them.
Infective exacerbations of COPD: antibiotics, corticosteroids, non-invasive ventilation and referral criteria.
Controlled oxygen therapy, target saturations and recognising type 2 respiratory failure.

Module 3: Respiratory assessment and acute presentations

The third module builds core assessment skills. It covers the systematic respiratory examination and the signs of pleural effusion, reading the chest radiograph for pneumothorax and effusion, and bronchiolitis in infants. Acute presentations are used to practise putting assessment findings together with drug therapy decisions.

How the course is taught

Every module pairs teaching with hands-on practice. You will work through branching clinical cases, prescribing scenarios checked against safety rules, and timed objective structured clinical examination (OSCE) stations. The asthma and COPD modules each end with a quiz. A final exam gates the certificate.

Doses used in teaching are examples for learning, not prescribing advice. The platform's deterministic rules, not the course text, decide whether a prescription is safe.

Who it suits

The course suits final-year medical and pharmacy students and foundation doctors who need to prescribe and review respiratory drugs safely. It also supports nurses and physician associates who want a structured refresher, provided they work within their local scope of practice.

Content provided through Oskela is intended for education and training. It is not a substitute for professional clinical judgment, institutional protocols, current formularies, prescribing information, or specialist consultation.

Curriculum

3 modules · 21 lessons

Covers the stepwise pharmacological management of chronic asthma in adults and children, the choice and correct use of inhaler devices, and the recognition and emergency treatment of acute severe asthma. Built around British National Formulary dosing and NICE-style guidance for learners preparing for finals and the Prescribing Safety Assessment.

Stepwise Management of Chronic Asthma: Preventers, Relievers and When to Step Up or DownPreview
This lesson follows a patient with chronic asthma from confirmation of the diagnosis through the stepwise approach used in UK practice. It separates preventer from reliever therapy, sets out inhaled corticosteroid starting points, and shows how add-on options such as long-acting beta-2 agonists, leukotriene receptor antagonists and maintenance and reliever therapy fit into the steps for adults and children. It stresses that adherence and inhaler technique must be checked and corrected before any step up, explains stepping down once control is sustained, and notes where guidance differs between regions. Doses quoted are teaching examples, not prescribing decisions.
10 min
Inhaler Devices and Technique: Choosing, Teaching and Checking Delivery Systems
This lesson covers how to choose an inhaler device and how to teach and check inhaler technique. It compares pressurised metered-dose inhalers, spacers and valved holding chambers, dry powder inhalers and soft mist inhalers, and sets out the patient and drug factors that drive device selection, including age, coordination, dexterity, inspiratory flow and the drug being delivered. It explains stepwise teaching and demonstration, the errors that most reduce lung deposition, and the use of spacers and face masks in children. It closes with how to check technique at review and when to consider changing device. Written for UK practice with British National Formulary dosing and NICE-style guidance. Device availability and local formularies vary, so always check what is commissioned locally.
10 min
Acute Severe Asthma in Adults and Children: Assessment, Emergency Treatment and Discharge
Acute asthma is a common emergency presentation and a frequent source of prescribing error. This lesson covers how to recognise and grade an exacerbation in adults and children from the history, observations and peak expiratory flow, including the features that mark a life-threatening attack. It then works through immediate treatment: controlled oxygen, nebulised short-acting beta-2 agonists with ipratropium, early systemic corticosteroids, and intravenous magnesium sulphate when the response is poor. Doses are given as teaching examples consistent with British National Formulary practice. The lesson also covers when to involve critical care, how to judge treatment failure and worsening fatigue, and safe discharge with a written action plan, inhaler technique check and follow-up. Practice varies by region, formulary and local protocol.
10 min
Case: Acute Asthma Exacerbation in a Child: A Case in Emergency Medicine
20 min
Prescribing: Acute Severe Asthma in a 24-Year-Old Woman
15 min
OSCE station: Inhaler Technique and Preventer/Reliever Explanation for Newly Diagnosed Asthma
11 min
Quiz: Asthma Management from Chronic Control to Acute Exacerbation
9 min

Covers the pharmacology and clinical use of long-acting bronchodilators and inhaled corticosteroids in COPD, the recognition and treatment of infective exacerbations, and the principles of controlled oxygen therapy. It builds the groundwork for interpreting arterial blood gases and recognising type 2 respiratory failure in acute-on-chronic disease.

Inhaled Therapy in COPD: Beta-2 Agonists, Muscarinic Antagonists and Corticosteroids
This lesson links the autonomic pharmacology of airway smooth muscle to the inhaled drugs used in COPD. It covers beta-2 receptor signalling and the long-acting beta-2 agonists, muscarinic M3 signalling and the long-acting muscarinic antagonists, and the role of inhaled corticosteroids, including eosinophil-guided use. Learners work through regimen selection for stable COPD, inhaler device choice and technique, adherence support, and the adverse effects they must counsel on. Dosing follows the British National Formulary as a teaching example; local formularies and NICE-style guidance vary, and the platform's rules, not this lesson, decide whether any prescription is safe.
10 min
Infective Exacerbations of COPD: Recognition, Assessment and Treatment
This lesson covers infective exacerbations of COPD in UK practice: how to recognise them, how to grade severity, and how to decide on antibiotics, oral corticosteroids and nebulised bronchodilators. It sets out the initial oxygen strategy and target saturations, the place of sputum culture and blood markers, and when non-invasive ventilation or critical care referral is indicated. Doses are teaching examples drawn from the British National Formulary: always check local guidance, the current formulary and the latest prescribing information. Content provided through Oskela is intended for education and training and is not a substitute for professional clinical judgment.
10 min
Controlled Oxygen and Type 2 Respiratory Failure: Targets, Masks and Blood Gases
This final lesson in the module covers oxygen as a drug in patients with COPD and other conditions that predispose to carbon dioxide retention. It explains why uncontrolled high-flow oxygen can worsen hypercapnia, sets out target saturations for patients at risk and not at risk of type 2 respiratory failure, and compares nasal cannulae, Venturi masks and reservoir masks with their approximate delivered oxygen concentrations. It then covers recognition of hypercapnic (type 2) respiratory failure, the principle that hypoxaemia is treated first and oxygen is never withheld from a hypoxic patient, and the use of arterial blood gases, particularly pH and PaCO2, to guide escalation to non-invasive ventilation. Teaching doses and target ranges are examples only; local protocols and current formularies take precedence.
10 min
Case: Drowsy COPD Exacerbation: A Clinical Case
20 min
Prescribing: Infective exacerbation of COPD with type 2 respiratory failure risk
15 min
OSCE station: Respiratory History: Breathlessness and Cough
11 min
OSCE station: Interpreting an Arterial Blood Gas in Acute-on-Chronic Type 2 Respiratory Failure
11 min
Quiz: COPD and Respiratory Failure: Inhaled Therapy, Infective Exacerbations and Controlled Oxygen
9 min

The third module of Respiratory Therapeutics covers bedside and radiographic assessment of acute respiratory presentations. It builds a systematic examination routine, then applies it to pleural effusion, to pneumothorax on the chest radiograph and to bronchiolitis in infants, noting where practice varies by region, formulary or local protocol.

The Systematic Respiratory Examination and the Signs of Pleural Effusion
This lesson teaches a stepwise bedside respiratory examination suitable for finals and foundation practice. You will work through inspection, palpation, percussion and auscultation in a fixed order, comparing right with left at each step. The lesson then applies that sequence to a right-sided pleural effusion, covering reduced chest expansion, a stony dull percussion note, reduced breath sounds and reduced vocal resonance, and explains the anatomy and physics behind each sign. It closes with a short structured way to present the findings and notes that signs vary with effusion size and rate of accumulation.
10 min
Reading the Chest Radiograph: Large Spontaneous Pneumothorax and Pleural Effusion
A structured method for reviewing a chest radiograph, applied to two acute presentations: a large left spontaneous pneumothorax and a pleural effusion. Working through a repeatable sequence (patient details, projection, rotation, adequacy, then a zone-by-zone review), the lesson identifies the pneumothorax by a visible pleural edge with absent lung markings beyond it, and distinguishes it from bullae and skin folds. It covers the deep sulcus sign on supine films, why supine pneumothorax is easily missed, and the significance of mediastinal shift. Effusion features, including costophrenic blunting and the meniscus, are reviewed, alongside supine appearances. The final section covers when lung ultrasound or CT adds information and outlines immediate management options: oxygen, needle decompression, aspiration and chest drain, noting that thresholds and drainage choices vary by local protocol.
10 min
Bronchiolitis in Infants: Assessment, Hypoxia and Supportive Management
This lesson covers the recognition and assessment of bronchiolitis in infants, focusing on age-appropriate observations and the significance of hypoxia on pulse oximetry. It explains supportive care including oxygen, feeding and fluid support, and nasal suction, and when to escalate to secondary care. It also explains why bronchodilators, corticosteroids and antibiotics are not routinely indicated, and where practice varies by local guidance. Written for final-year medical and pharmacy students and foundation doctors in UK practice.
10 min
Case: Bronchiolitis in a 4-month-old with hypoxia
20 min
OSCE station: Respiratory Examination: Right-Sided Pleural Effusion
11 min
OSCE station: Chest X-ray Interpretation: Large Left Spontaneous Pneumothorax
9 min

Before you start

Completed a foundation course in respiratory anatomy and physiology, including gas exchange and lung mechanics.
Basic autonomic pharmacology, including beta-2 adrenergic receptors, muscarinic receptors and the action of corticosteroids.
Confidence in taking a focused history and performing a basic physical examination in a clinical skills setting.

Who this is for

Final-year medical students preparing for finals and the Prescribing Safety Assessment.
Final-year pharmacy students preparing for prescribing or clinical pharmacy assessments.
Foundation doctors in their first two years of practice who review respiratory patients.
Nursing students on respiratory or acute medical placements.

Your instructor

Platform Administrator

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