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Therapy-556 > COPD > Flashcards

COPD Flashcards

1
Q

Chronic Obstructive Pulmonary Disease (COPD)

A

-PERSISTANT respritory symptoms
-airflow limitation
-PROGRESSIVE
-exacerbations
-comorbities

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2
Q

true or false: deaths resulting from COPD are higher in women than in men

A

true.

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3
Q

COPD prevalence

A

-3rd leading cause of death
-affects females more than males
-affects American indians/alaskan native descendants more

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4
Q

COPD pathophysiology

A

-emphesema and chronic bronchitis

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5
Q

what is required for COPD diagnosis?

A

spirometry test
-FEV1/FVC <70% post bronchodialator

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6
Q

COPD symptoms

A

-dyspnea
-chronic cough
-sputum production
-wheezing, chest tightnes
-lower respritory tract infections

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7
Q

COPD risk factors

A

-exposure to particles
-Socioeconomi status
-age and sex
-genes
-asthma, chronic bronchitis
-childhood lung abnormalities

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8
Q

Emphysema

A

-in aveoli
-destruction of lung parenchyma
-decreased lung elasticity
-causes SOB, wheezing

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9
Q

chronic bronchitis

A

-inflammation in the airways(bronchi)
-mucus overproduction

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10
Q

COPD stimulus

A

-cigarette smoke
-over pollutants

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11
Q

how often to get spirometry performed?

A

1 x/year

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12
Q

Does COPD have reversibility?

A

No

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13
Q

COPD spirometry values

A

post bronchodilator FEV1/FVC <0/7

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14
Q

Gold 1: mild

A

FEV1 > 80%

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15
Q

Gold 2: moderate

A

50<FEV1< 80%

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16
Q

Gold 3: severe

A

3-50% FEV1

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17
Q

COPD stable, initial treatments

A

-SABA/LABA
-SAMA/LAMA
-or combo products

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18
Q

Lonhala Magnair

A

-nebulized Glycopyrrolate
-BID 2-3 min each

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19
Q

Yupelri

A

-Revefenacin Neb soln
-3 ml
-once daily for 10 min

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20
Q

LAMA side effects

A

-dry mouth
-bitter taste
-nasopharyngitis
-urinary retention

-worsening of narrow angle glaucoma

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21
Q

LAMA Use in therapy

A

-NOT rescue meds
-do not treat acute COPD symptoms

22
Q

Yupelri drug interactions

A

-OATP1B1
OATP1B3
-rifampin
-cyclosporine

23
Q

Brovana

A

-aformoterol neb soln

24
Q

Perforomost

A

formoterol neb soln

25
LABA side effects
-sinus tachycardia -cardiac rhythm disturbances
26
LABAs place in therapy
-monotherapy for patients with mild or moderate COPD -not rescue medications
27
Considerations for LABAs
-other QTc prolong medications -MAOI
28
LABA/LAMA combo products
-Anoro -
29
Anoro ellipta
-umeclidium and vilanterol -interacts with ketoconazole
30
LABA/LAMA place in therapy
-step up therapy if patient is still symptomatic
31
SABA
-threat acute symptoms
32
ICS
-should not be monotherapy -should be used in tripple therapy -may even reduce mortality
33
risk of ICS in COPD
-higher incidence of pneumonia -oral candiasis -hoarse voice
34
Eosinophils
-key factor in deciding if patient recieves ICS
35
COPD and asthma
-treat like patients with asthma -always use ICS
36
ICS: Factors strongly favor use
-hospitilization for COPD -> 2 mod exacerbations last year -eosinophils>300
37
ICS: Factors favor use
-1 mod exacerbation -eosinophil 100-300
38
ICS: Factors againist use
-repeated pneumonia events -eosinophil <100 -hx of mycobacterial infection
39
COPD Assessment Test (CAT)
-Higher CAT score is worse symptoms ->30 very high impact
40
Initial: Cat <10 and 0-1 exacebations
Bronchodialator
41
Initial: Cat >10 and 0-1 exacebations
LABA + LAMA
42
Initial: anyone who has had more than 2 exacerbations or 1 leading to hospitalization
-LABA+LAMA -triple therapy if eosinophils>300
43
Roflumilast
-decrease risk of COPD exacebations in SEVERE AND VERY SEVERE COPD -FEV1<50% -chronic broncitis -history of exacerbations
44
Roflumilast side effects
-psychiatric events -weight loss( 2 kg) -GI upset, diarrhea
45
Roflumilast drug interactions
-strong CYP450 inducers -carbamazapine =phenytoi -phenobarbital -rifampin
46
Roflumilast contraindications
-mod to severe liver impairment
47
Azithromycin
-for severe COPD AND not a current smoker
48
Azithromycin side effects
-prolong QTc -impaired hearing -increase bacterial resistance
49
Dupilumab
-studied in people eosinophils>300
50
Ensifentrine
-nebulizer -dual PDE3 and PDE4 inhibitor -bonchodialator -anti inflammatory
51
step down from ICS therapy
-cold turkey -worse withdrawal with patients that have higher eosinophils

Therapy-556 (10 decks)

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