COPD

Question 1

diagnosis of COPD

Answer 1

smoking more than 10 years
sputum production
non allergic symptoms
symptoms are persistent
disease worsens overtime
excerbation
spirometry test to measure FVC and FEV
FEV1/FVC <0.7 is positive for COPD

Question 2

GOLD 1

Answer 2

mild
FEV>80

Question 3

GOLD 2

Answer 3

moderate
FEV between 50-80%

Question 4

GOLD 3

Answer 4

severe
FEV between 30-50

Question 5

GOLD 4

Answer 5

Very Severe
FEV <30%

Question 6

WHat are some tests to determine symptoms severity

Answer 6

CAT- COPD assessment test
Dyspnea scale

Question 7

What is ABCD

Answer 7

more like CDAB

Question 8

drug treatment for COPD

Answer 8

bronchodilators 1st line with
SABA
SAMA
** long term oral mono therapy is not recommended
** ICS for pt with high eosinophil count

Question 9

Group A pts treatment

Answer 9

SABA/SAMA prn
LABA or LAMA

Question 10

group B tx

Answer 10

LAMA / LABA

Question 11

group C

Answer 11

LAMA

Question 12

group D tx

Answer 12

LAMA
LAMA plus LABA
LABA plus ICS

Question 13

escalation of tx

Answer 13

if dyspnea starrt with LAMA add LABA/LAMA
if exacerbation LAMA/LABA + LABA?LAMA or LABA ICS

refer to pg 599

Question 14

is mono therapy with oral steroid or iCS recommended

Answer 14

NOPE

Question 15

when is ICS added on

Answer 15

Hihg esonophils

Question 16

last line of tx after LABA LAMA ICS

Answer 16

azithro/ roflimilast

Question 17

which class of broncho dilators are good for exhacerbations

Answer 17

LAMA

Question 18

what are some SAMA

Answer 18

iprotopiunm - Atrovent +albuterol, combivent

Question 19

what are some LAMA

Answer 19

tiotropium- spiriva, aclemdium, umeclidinium (incruse)

Question 20

what are some notes on Muscuranic antagonist

Answer 20

dry mouth
handinhaler comes with a capsule for inserting not taking orally

Question 21

LABA

Answer 21

salmeterol +fluticasone (advair)
formoterol + budesonide (symbicort
vilanterol +fluticasone (breo ellipta)

Question 22

what is only available in combination

Answer 22

Vilanterol

Question 23

what are some notes on long acting beta 2 agonist

Answer 23

tremor,
tachy cardia,
palpitation,
hyperglycemia
hypokalmeia

Question 24

MOA of SAMA/LAMA

Answer 24

bronchodilation by blocking ach contriction at M3 bronchial smooht muscle

Question 25

MOA of LABA

Answer 25

relaxation of bronchoil smooth m,uske

Question 26

what are some notes on ICS

Answer 26

after use rinse mouth with water and spit to avoid oral candidiasis

Question 27

counselling metered dose inhaler like Atrovent HFA

Answer 27

do not shake
spray 2 times and prime again in >3 days
clean weekly removing metal cannister with warm water running 30 sec
keep eyes closed when using
breath slowly and deeply through mouth

Question 28

what are resimat products

Answer 28

albuterol/ipotropium =combivent
oldaterol/tiotropium
oldaterol
tiotropium

Question 29

counselling on resimat prducts

Answer 29

TOP
Turn- with cap closed until clicks
open- cap until it snaps fully, breathe out slowly and fully
press- while breathing in slowly and deeply

prime- point towards the ground and press until spray is visible then 3 more times
clean with damp cloth weekly

Question 30

tiotropium counseling dry powder inhalers handhaler

Answer 30

do not need to prime
clean as needed with running water let air dry

open insert green button inhale twice

Question 31

aclidium tudorza pressair

Answer 31

remove protective cap pulling the arrow
press green button all the way down
control window should turn from red to green
breathe out
breathe in quickly and deeply until click sound
breathe out
cehck control should turn red

Question 32

ellipta products

Answer 32

open cover
breath fully out
inhale do not block airvent
rinse mouth for ICS products