COPD Flashcards Preview

Z A Pharm III > COPD > Flashcards

Flashcards in COPD Deck (49):
1

COPD def

preventable and treatable
progressive persistent airflow limitation
chronic inflammatory response in airways
caused by noxious particles or gases

2

how many cig smokers get COPD

15-20%

3

Where does COPD rank for death

3rd

4

What are COPD risk factors

smoking
indoor air pollution
occupational dust and chemicals
outdoor air pollution

5

How COPD affects lungs

mucus hypersecretion
ciliary dysfunction
airflow limitation
hyperinflation
gas exchange abnormalities
pulmonary hypertension
systemic effects

6

What are symptoms of COPD

dyspnea
chronic cough
chronic sputum production
exacerbations

7

What is required to diagnosis COPD

spirometry

8

What are the stages of COPD

GOLD 1 - Mild
GOLD 2 - Moderate
GOLD 3 - Severe
GOLD 4 - Very Severe

9

What are symptoms of GOLD 1 for COPD

FEV1 >= 80%
no chronic symptoms

10

What are symptoms of GOLD 2 for COPD

FEV1 between 50 and 80%
DOE

11

What are symptoms of GOLD 3 for COPD

FEV1 Between 30 and 50%

12

What are symptoms of GOLD 4 for COPD

FEV1 < 30%

13

What txt goals COPD

smoke
reduce symptoms
improve exercise tolerance
minimize rate decline
maintain QOL
prevent exacerbations
limit complications

14

What are the COPD management pgm

assess and monitor disease
reduce risk factors
manage stable COPD
manage exacerbations

15

What are nonpharm COPD txts

smoking cessation
pulmonary rehab for GOLD 3 and 4 or B,C,D
O2
Surgery

16

What are pharm txts

Bronchodilators
corticosteroids

17

What are MOA anticholinergic bronchodilators

decrease cyclic GMP and cause bronchial smooth muscle relaxation

18

What are adverse effects anticho bronchodilators

dry mouth
metallic taste
dry eyes
urinary retention
constipation

19

What are the anticho broncho meds

Ipratropium
Tiotropium

20

How use Ipratropium

short acting
2 puffs qid (12 in 24 hrs)
MDI or neb

21

How use tiotropium

long acting
18 mcg inhaled via DPI qd

22

What do cholinergic agents do

Salivation
Lacrimation
Urination
Defecation

23

What are MOA B-2 agonists

stimulate B-2 receptors
increase CAMP
relax bronchial smooth muscle

24

What are adverse effects B-2 agonists

tachycardia
tremor
hypokalemia

25

What are the B-2 meds

Albuterol MDI
Salmeterol MDI

26

How use albuterol MDI

Short acting
2 puffs q4-6 hr prn

27

How use Salmeterol

long acting
1 inhalation q12h

28

When use combo short acting bronchodilators

FEV1 < 60%
Combivent (ipratropium + albuterol)
2 puffs qid

29

What is MOA methylxantine bronchodilator

block phosphodiesterase
Increase CAMP
relax bronchi and pulmonary blood vessel smooth muscle

30

What are adverse effects of methylxantine bronchodilator

drug interactions
restlessness
insomnia
GERD
palpitations
diuresis
NVD
headache

31

What is a methylxantine bronchodilator med

Theophylline

32

When should ICS be used

FEV1 < 60%

33

What are adverse effects of ICS

pneumonia
candidiasis
hoarse voice

34

What should a ICS be used with for COPD

LABA

35

What is a ICS med

Fluticasone
88-440 mcg bid

36

What is phosphodiesterase 4 inhibitor MOA

inhibit PDE4 involved with CAMP

37

What are adverse effects with phosphodiesterase 4 inhibitor

hepatic impairment
insomnia
weight loss
depression
suicide
D/N

38

What is a phosphodiesterase 4 inhibitor med

Daliresp 500 mcg po qday

39

What immunizations should COPD pts get

Influenza
Pneumococcal >65 age or FEV1 < 40%

40

What are patient group A for COPD

GOLD 1 or GOLD 2
CAT < 10

41

What are patient group B for COPD

GOLD 1 or GOLD 2
CAT >= 10

42

What are patient group C for COPD

GOLD 3 or GOLD 4
CAT < 10

43

What are patient group D for COPD

GOLD 3 or GOLD 4
CAT >= 10

44

How treat Patient group A COPD

SAAC
or
SABA

45

How treat patient group B COPD

LAAC
or
LABA

46

How treat patient group C COPD

ICS + LABA
or
LAAC

47

How treat patient group D COPD

ICS + LABA
and/or
LAAC

48

What monitoring and follow-up is required for COPD

spirometry >= every year
Questionaires 2-3 months
symptoms each visit
smoking each visit
meds and inhaler technique
exacerbation history
comorbidities

49

How treat COPD exacerbations

SA bronchodilators
Oral corticosteroids (prednisone 40 mg po qd 5 days)
antibiotics ( sputum purulence and dyspnea/sputum volume)