Flashcards in COPD Deck (25):
This disease is caused by 1 or combination of these disorders which causes airway ________ and ________?
Emphysema, asthma, chronic bronchitis. Limitations and obstructions
All structures of the acinar are affected by this type of emphysema and is caused by?
Panacinar, alpha-1 antitrypsin deficiency
This type of emphysema affects respiratory bronchioles is is caused by?
Centriacinar, cigarette smoking, coal mining
The decrease in expiratory airflow in COPD is caused by?
elasticity of the lungs
Is defined by productive cough that last 3 months and occurs two years in a row?
These are two hallmarks of COPD?
inflammation and partially or non-reversible airflow obstruction
Clinical manifestations of COPD?
Dyspnea, cough, sputum production, weight gain or loss, decreased sexual activity, cough syncope, depression or anxiety
Single best indicator of COPD?
decline in FEV1
Physical exam findings of severe COPD?
Barrel chest, prolonged expiratory phase, accessory muscle recruitment, wheezing and rhonchi, cyanosis
Diagnostic testing for COPD?
pulse ox, chest xray, PFT, CT of lungs
FEV1/FVC indicator of COPD?
CXR findings for COPD?
Hyperinflation, flattened diaphragms, decreased vascular markings
Options for smoking cessation?
Varenicline (Chantix), wellbutrin, nortriptyline, nicoderm CQ, habitrol patches
Dosing for Varenicline (Chantix)
Initial dose: 0.5mg x 3 days, 0.5mg BID x 4 days, 1g BID x 11 weeks
Side effects of Varenicline
GI distress, headache, vivid dreams, suicidal thoughts and depression
Treatment of stable COPD
bronchodilators (beta agonist, anticholinergics) ICS
Short acting bronchodilators (beta agonist)
Albuterol and levalbuterol
Ipratropium (atrovent) short acting. Titotropium (spiriva) or Aclinidium (tudorza) long acting
long acting beta-2 agonist
Salmeterol (Serevent), Formoterol (foradil)
ICS are used with these medications and should not be taken as?
LABA or anticholinergic. Should not be taken as monotherapy
Beclomethasone (Qvar), budesonide (pilmicort), fluticasone (flovent), mometasone (Asmanex)
Combination ICS + LABA?
Budesonide + Formoterol (Symbicort), Flucticasone + Salmeterol (Advair), Vilanterol + Fluticasone (breo ellipta)
This medication can be added onto triple combination thereapy for refractory disease?
low dose theophylline. not use alot in the US. levels need monitored due to toxicity
Oral medication that decreased airway inflammation?
PDE-4 inhibitors (phosphodiesterase 4 inhibitor)