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Hugh's MD2 Foundation > COPD > Flashcards

Flashcards in COPD Deck (27):
1

What is the mechanism of action of tiotropium (spiriva)

It's an anticholinergic - Blocks M3 muscarinic receptors on smooth muscle cells and submucosal glands to reduce bronchocontriction and mucus secretion

2

Why does lung reduction surgery help in COPD?

Bad lung impinges on good lung

3

In which airways does inflammation generally occur? What is the consequence?

Peripheral

Fibrosis and obliterative bronchiolitis

3

What are some side effects of anticholinergics?

Dry mouth

4

Define COPD

A progressive condition of irreversible airflow limitation due to an ongoing, abnormal inflammatory response to noxious stimuli

4

Describe 4 microscopic aspects of the COPD pathophysiology

Destruction of alveolar septa

Loss of elasticity

Inflammatory cell infiltrate - Neutrophils, macrophages, CD8+

Destruction of pulmonary capillary bed

5

What are some long acting beta2 agonists used in COPD?

Salmeterol

Eformaterol

Indacaterol (ultra long acting)

6

Name some anticholinergics used in COPD (including tradenames)?

Tiotropium (spiriva)

Ipratropium (atrovent)

7

What is chronic bronchitis?

Inhalation of a noxious stimulus that causes production of mucus chronically

8

What therapies can be used in exacerbations?

O2

Antibiotics

Bronchodilators

Corticosteroids

Physical activity

Non-invasive ventilation

9

What is seratide a combination of?

Salmeterol and fluticasone

11

How do you make the diagnosis of COPD?

Spirometry

12

When are inhaled corticosteroids indicated in COPD?

FEV1

13

What is the benefit of oxygen home therapy?

Improves mortality

Reduces pulmonary hypertension

14

Why might FVC be low in COPD lungs?

Gas trapping

15

What are some physical signs of COPD?

Hyperresonance to purcussion

Barrel chest

Dull breath sounds

 

17

Describe the epidemiology of COPD

3rd leading cause of disease burden in Aus

500,000 Australians have moderate COPD

18

By what factor is FER reduced for COPD to be diagnosed?

FER = <0.7

(FER = FEV1 / FVC)

19

What is pulmonary rehabilitation?

Patients develop mastery of their airways

20

How does the pattern of inflammation differ in asthma cf COPD?

Inflammation affects all airways in asthma

Fibrosis isn't a major factor in asthma cf in COPD where it is

21

In terms of cell type, what type of inflammation in present in COPD?

Neutrophilic

22

By what method is the severity of COPD graded?

Percentage of predicted FEV1

23

What are some pharmalogical methods of smoking cessation?

Nicotine patches

Bupropion (Zyban)

Varenicline (Champix)

24

When are inhaled steroids indicated in COPD?

When the disease is severe with an FEV1 <50% predicted

25

What is symbicort?

Budesonide and formoterol

26

When is home oxygen therapy indicated?

When PaO2 is <55mmHg or <60mmHg with hypoxic symptoms

No cigarettes for 3 months

27

What are some causes of exacerbations of COPD?

Respiratory infection

Heart failure

Arrhythmia

Systemic infection

Anaemia

Anxiety

Any increase in basal metabolic rate