54 - COPD Flashcards Preview

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Flashcards in 54 - COPD Deck (30):
1

_____ is a big modifiable risk factor

smoking

2

FEV1 < ___% of the predicted value is necessary to establish the diagnosis along with a decreased FEV1/FVC

80

3

non-pharms

-stop smoking
-avoid exposure to pollution/chemicals, encourage physical activity
-action plan
-Aerobika device may improve lung function

4

Increased mortality with ____ monotherapy

ICS

5

Role of ICS in COPD?

only as part of ICS/LABA combo since ICS monotherapy increases mortality

6

Stable COPD and prevention of acute exacerbations:
______ are the mainstay of therapy (PRN of scheduled)

bronchodilators

7

Stable COPD and prevention of acute exacerbations:
Recommend ___ use of a SABA as increased doses can cause tachycardia, tremor and potential hypokalemia

PRN

8

Stable COPD and prevention of acute exacerbations:
Do oral beta agonists have any role in COPD

no

9

Stable COPD and prevention of acute exacerbations:
What is a 1st line option?

LAMA (tiotropium)

*ipratropium can increase CV events

10

Stable COPD and prevention of acute exacerbations:
Can also use LABAs, give 2 examples

-salmeterol
-formoterol

11

Stable COPD and prevention of acute exacerbations:
There are 2 ultra long acting LABAs, what are they?

*only used for COPD, not asthma

-indacaterol
-olodaterol

12

Stable COPD and prevention of acute exacerbations:
ICS/LABA may have increased risk of _____ compared to LABA monotherapy

pneumonia

13

Stable COPD and prevention of acute exacerbations:
Who would you consider triple therapy in? (ICS/LABA with LAMA)

in those with mod-severe COPD and > 2 exacerbations/year or > 1 requiring hospitalization

14

Stable COPD and prevention of acute exacerbations:
ICS therapy can increase risk of contracting or reactivating _______

tuberculosis

15

What vaccines do COPD patients need?

flu and pneumococcal

16

Stable COPD and prevention of acute exacerbations:
Give an example of PDE4 inhibitor

roflumilast

17

Stable COPD and prevention of acute exacerbations:
How does Roflumilast work? (PDE4 inhibitor)

suppresses release of inflammatory mediators (PO med)

18

Stable COPD and prevention of acute exacerbations:
s/e of Roflumilast? (PDE4 inhibitor)

-nausea, diarrhea and weight loss
-neuropsych effects

19

Stable COPD and prevention of acute exacerbations:
Can use theophylline for severe symptoms. What is the therapeutic range?

55-85 mcmol/L

20

Stable COPD and prevention of acute exacerbations:
Can use theophylline for severe symptoms. Levels may increase if what?

patient stops smoking or is taking clarithromycin (CYP 3A4 inhibitor)

21

Stable COPD and prevention of acute exacerbations:
People with low Vitamin ___ may supplement to maybe decrease exacerbations

D

22

Stable COPD and prevention of acute exacerbations:
Can use ____ therapy if severe

oxygen

23

Stable COPD and prevention of acute exacerbations:
Can try ______ antibiotic therapy if need prevention and risks don't outweigh benefits

*consider patients risks for QTc prolongation, ototoxicity and AB resistance

macrolide

24

Stable COPD and prevention of acute exacerbations:
Current ______ will not benefit from antibiotic therapy

smokers

25

Treatment of Acute Exacerbations of COPD:
Should increase dose/frequency of existing bronchodilator?

yes

26

Treatment of Acute Exacerbations of COPD:
Treat dyspnea with what?

SABA and ipratropium (SAMA)

27

Treatment of Acute Exacerbations of COPD:
Can use what else for exacerbations?

-corticosteroids
-antibiotics

28

Treatment of Acute Exacerbations of COPD:
When should corticosteroids be given to reduce risk of further exacerbations?

within 30 days of an acute exacerbation

29

Treatment of Acute Exacerbations of COPD:

For COPD without risk factors, what are the first line antibiotics?

-amox
-doxy
-sulfa trim or macrolide

30

Treatment of Acute Exacerbations of COPD:

For COPD with risk factors, what do you use?

-amox/clav
-cephalosporin 2nd gen
-FQ

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