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PEBC > 54 - COPD > Flashcards

54 - COPD Flashcards

1
Q

_____ is a big modifiable risk factor

A

smoking

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2
Q

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

A

80

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3
Q

non-pharms

A
  • stop smoking
  • avoid exposure to pollution/chemicals, encourage physical activity
  • action plan
  • Aerobika device may improve lung function
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4
Q

Increased mortality with ____ monotherapy

A

ICS

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5
Q

Role of ICS in COPD?

A

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

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6
Q

Stable COPD and prevention of acute exacerbations:

______ are the mainstay of therapy (PRN of scheduled)

A

bronchodilators

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7
Q

Stable COPD and prevention of acute exacerbations:

Recommend ___ use of a SABA as increased doses can cause tachycardia, tremor and potential hypokalemia

A

PRN

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8
Q

Stable COPD and prevention of acute exacerbations:

Do oral beta agonists have any role in COPD

A

no

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9
Q

Stable COPD and prevention of acute exacerbations:

What is a 1st line option?

A

LAMA (tiotropium)

*ipratropium can increase CV events

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10
Q

Stable COPD and prevention of acute exacerbations:

Can also use LABAs, give 2 examples

A
  • salmeterol

- formoterol

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11
Q

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

*only used for COPD, not asthma

A
  • indacaterol

- olodaterol

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12
Q

Stable COPD and prevention of acute exacerbations:

ICS/LABA may have increased risk of _____ compared to LABA monotherapy

A

pneumonia

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13
Q

Stable COPD and prevention of acute exacerbations:

Who would you consider triple therapy in? (ICS/LABA with LAMA)

A

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

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14
Q

Stable COPD and prevention of acute exacerbations:

ICS therapy can increase risk of contracting or reactivating _______

A

tuberculosis

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15
Q

What vaccines do COPD patients need?

A

flu and pneumococcal

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16
Q

Stable COPD and prevention of acute exacerbations:

Give an example of PDE4 inhibitor

A

roflumilast

17
Q

Stable COPD and prevention of acute exacerbations:

How does Roflumilast work? (PDE4 inhibitor)

A

suppresses release of inflammatory mediators (PO med)

18
Q

Stable COPD and prevention of acute exacerbations:

s/e of Roflumilast? (PDE4 inhibitor)

A
  • nausea, diarrhea and weight loss

- neuropsych effects

19
Q

Stable COPD and prevention of acute exacerbations:

Can use theophylline for severe symptoms. What is the therapeutic range?

A

55-85 mcmol/L

20
Q

Stable COPD and prevention of acute exacerbations:

Can use theophylline for severe symptoms. Levels may increase if what?

A

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

21
Q

Stable COPD and prevention of acute exacerbations:

People with low Vitamin ___ may supplement to maybe decrease exacerbations

A

D

22
Q

Stable COPD and prevention of acute exacerbations:

Can use ____ therapy if severe

A

oxygen

23
Q

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

A

macrolide

24
Q

Stable COPD and prevention of acute exacerbations:

Current ______ will not benefit from antibiotic therapy

A

smokers

25
Q

Treatment of Acute Exacerbations of COPD:

Should increase dose/frequency of existing bronchodilator?

A

yes

26
Q

Treatment of Acute Exacerbations of COPD:

Treat dyspnea with what?

A

SABA and ipratropium (SAMA)

27
Q

Treatment of Acute Exacerbations of COPD:

Can use what else for exacerbations?

A
  • corticosteroids

- antibiotics

28
Q

Treatment of Acute Exacerbations of COPD:

When should corticosteroids be given to reduce risk of further exacerbations?

A

within 30 days of an acute exacerbation

29
Q

Treatment of Acute Exacerbations of COPD:

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

A
  • amox
  • doxy
  • sulfa trim or macrolide
30
Q

Treatment of Acute Exacerbations of COPD:

For COPD with risk factors, what do you use?

A
  • amox/clav
  • cephalosporin 2nd gen
  • FQ

PEBC (130 decks)

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