COPD Flashcards

(36 cards)

1
Q

define COPD

A

COPD is an umbrella term for 2 conditions: chronic bronchitis (chronic inflammation of the bronchioles that is filled with thick mucus) and emphysema (damage to the alveolar pockets and membrane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a COPD exacerbation?

A

a “flair up” that causes a decline in respiratory function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risk factors for COPD?

A

smoking, biomass fuel heating, childhood asthma and diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why is COPD the only chronic disease in which mortality is still increasing?

A

-aging population and cumulative exposure to COPD risk factors– tobacco smoke, biomass fuel heating (in non-ventilated area), asthma, childhood respiratory disease
-better at treating other diseases when COPD effects appear later in life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the pathophysiology of COPD?

A

-COPD is an umbrella term for chronic bronchitis and emphysema
-airflow obstruction
-hypersecretion of mucus
-inflammation
-parenchymal changes
-pulmonary vascular thickening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does rhonchi indicate?

A

excess/thickened mucus in the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does wheezing indicate?

A

airflow obstructed by bronchi being too constricted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the pathway to the diagnosis of COPD

A

Symptoms:
-SOB
-chronic cough
-sputum

Risk factors:
-host factors
-tobacco
-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the diagnostic test done for COPD?

A

spirometry
-results that support COPD are <0.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain the formula FEV1/FVC<0.7

A

this is the formula that indicates the pt has COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the scale for dyspnea?

A

MMRC: grades the disability of dyspnea based on ability to walk/exercise on a level plane, uphill, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain the COPD assessment test (CAT)

A

-measures the impact of COPD on a patient’s health status
-when changing medications, we want a change of at least 2 points
-score range of 0-40 with 40 being having a great affect on their day-to-day life
-not a tool for symptom assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the BODE index?

A

a diagnostic tool used to prognosticate survival using 4 categories: BMI, dyspnea, walking test, obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is an acute exacerbation of COPD?

A

a sudden “flair up” of COPD that causes a decline in respiratory function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a moderate acute exacerbation of COPD?

A

requires the use of antibiotics or systemic corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a severe acute exacerbation of COPD?

A

requires a trip to the ER/hospital admission

17
Q

Define low-risk of exacerbation

A

1 or less moderate exacerbations of COPD within the last year

18
Q

Define high-risk of exacerbation

A

2 or more moderate exacerbations or 1 or more severe exacerbation within the last year

19
Q

What does the suffix “-ium” indicate?

A

LAMA– long acting muscarinic antagonist
-a once daily inhaler
-Tiotropium, Spiriva

EXCEPT!! Ipratropium which is a SAMA

20
Q

What does the suffix “-erol” indicate?

A

LABA– long acting beta2 agonist
-Formoterol, Salmeterol, Indacaterol

21
Q

What does the suffix “-one” indicate?

A

Corticosteroid

22
Q

What does the suffix “-ol” indicate?

A

SABA– short acting beta2 agonist
-Salbutamol, Albuterol, Ventolin
-rescue inhaler
-rapid onset of 1-5 min

23
Q

What is Trelegy?

A

-a LAMA, LABA, ICS combo drug
-only one in Canada that is a combo of the 3
-for patients who are not adequately treated with dual therapy, taken once daily

24
Q

What is used to prevent AECOPD?

A

Mucomyst and Daxas

25
What should not be used to prevent AECOPD?
-oral slow-release Theophylline as it is shown NOT to prevent AECOPD -had many side effects -as of 2019
26
Who can do a referral to Pulmonary Rehab?
can be done by any HCP including nurses, patients can also refer themselves
27
When is a patient nearing EOL with COPD?
1) severe , acute exacerbations (recurrent hosptial admissions, >3/12 months) 2) FEV1<30% 3) signs of pulmonary HTN 4) respiratory failure with CO2 retention 5) BMI <20kg/m^2 6) the pt is starting to wish or talk about death 7) would I be surprised if this pt died this year?
28
What is the #1 symptom of COPD?
dyspnea
29
What positioning should the patient do to help with dyspnea?
tripod
30
What is goal-directed oxygen therapy?
-keep the pt within the O2 sat range but with the least amount of supplemental oxygen
31
Explain the proper use of opioids for dyspnea relief
-not nebulized -doses smaller than used for pain control -titrate slowly to lowest effective dose -morphine or hydromorphone -for incident dyspnea use fentanyl or sufentanil
32
What is the second line treatment for dyspnea?
anxiolytics and antidepressants (should NOT be used routinely for management of dyspnea in advanced COPD)
33
Describe pulmonary cachexia
-independent predictor of mortality -contributing factors include hypermetabolic state (increased WOB uses 10x as much energy expenditure to breathe) and anorexia
34
What are the pharmacological interventions for pulmonary cachexia?
Megesterol Acetate-- helps increase appetite and weight, does not increase lean body weight
35
What are the non-pharmacological interventions for pulmonary cachexia?
-dietary consult -small, frequent means that are high in fiber and protein, low in carbs -decrease gas-forming foods (broccoli, cabbage) -easy meals (microwave, ensure) -rest before meals, multivitamin -regular exercise to help conditioning
36
What is Venlafaxine used for?
treatment of both anxiety and depression related to COPD