chronic obstructive diseases

Question 1

What is the treatment for alpha 1 antitrypsin deficiency?

Answer 1

IV pooled alpha 1 antitrypsin

Question 2

What’s the first line for COPD?

Answer 2

smoking cessation and vaccination

Question 3

What group of medications do you give for a COPD patient with 2+ moderate exacerbations or 1+ leading to a hospitalization in the past year?

Answer 3

Group E- LAMA + LABA or ICS + LABA + LAMA for eos 300+

Question 4

What group of medications do you give for COPD pt with 0-1 exacerbations with no hospital admissions in past year?

Answer 4

Group A (LABA OR LAMA) or B (LABA AND LAMA)

Question 5

COPD Group A tx

Answer 5

LABA OR LAMA

Question 6

COPD Group B tx

Answer 6

LABA AND LAMA

Question 7

COPD Group E tx

Answer 7

LAMA+LABA (highly symptomatic) or ICS + LABA + LAMA (eos>300)

Question 8

How do you treat COPD outpatient?

Answer 8

O2 for at least 15 hours a day is only treatment to lengthen life.
Smoking cessation.
Vaccinations.
Bronchodilators.
Pulmonary rehabilitation.
May do sx

Question 9

What medications can you use to improve symptoms in COPD?

Answer 9

inhaled bronchodilators but stop if doesn’t help

Question 10

What helps COPD in severe exacerbations with eos>300?

Answer 10

Inhaled corticosteroids

Consider de-escalation of ICS if pneumonia or other considerable side effects. More likely to develop exacerbations if blood eos still 300+

Question 11

What med is used in COPD for patients who don’t improve with anything else and require monitoring?

Answer 11

theophylline

Question 12

What COPD med is used only for
1) acute exacerbation (increased sputum, purulence, dyspnea)
2) acute bronchitis
3) prophylaxis for bronchitis?

Answer 12

abx

Question 13

What med is for COPD for those taking LABA and LAMA w or w/o ICS w exacerbations, FEV <50%, and chronic bronchitis?

Answer 13

roflumilast (phosphodiesterase type 4 inhibitor)

Question 14

How do you treat bronchiectasis?

Answer 14

airway clearance techniques w/ pretreatment of bronchodilators, expectorants, humidifiers.
Antibiotics for frequent exacerbations.
Resection or transplantation of lung

Question 15

How do you treat severe bronchiectasis?

Answer 15

long term abx for 3+ exacerbations/year.. may need lung resection/transplant

Question 16

name a LAMA

Answer 16

tiotropium

Question 17

name a LABA

Answer 17

salmeterol, formoterol

Question 18

name a SABA

Answer 18

albuterol, levalbuterol

Question 19

name a SAMA

Answer 19

ipatropium

Question 20

name an ICS

Answer 20

budesonide, fluticasone

Question 21

What are the new guidelines for COPD Group A?

Answer 21

LABA or LAMA

Question 22

What are the new guidelines for COPD Group B?

Answer 22

LAMA+LABA

Question 23

What are the new guidelines for COPD Group E?

Answer 23

LAMA + LABA
LAMA + LABA + ICS w/ eos>300