COPD therapies Flashcards
(26 cards)
What are the long-term management options for patients with COPD
Stop smoking, pneumococcal and annual influenza vaccine, pulmonary rehabilitation
What is the first step in COPD medical management?
SABA or SAMA
What is an example of a SABA
Salbutamol
What is an example of a SAMA
ipratroprium bromide
What is the 2nd step in COPD medical management if they are not asthmatic or have any other steroid-responsive features?
LABA and a LAMA combination inhaler
What is an example of a LABA and LAMA combination inhaler?
“Anoro Ellipta”
What is the 2nd step in COPD medical management if they are asthmatic or have any other steroid-responsive features?
Combined LABA plus an ICS
What is an example of a combined LABA plus ICS?
“Fostair”
What would you prescribe if both the 2-compartment combination inhalers don’t work?
LABA, LAMA and ICS
What are the additional options in more severe cases of COPD?
Nebulisers, oral theophylline, and oral mucolytic therapy to break down sputum, long term prophylactic antibiotics, long term oxygen therapy at home
What are the symptoms of an exacerbation of COPD?
worsening cough, shortness of breath, sputum production and wheeze.
What is an exacerbation of COPD usually triggered by?
viral or bacterial infection
What is the treatment for exacerbation of COPD if they are well enough to remain at home?
Prednisolone 30mg once daily for 7-14 days
Regular inhalers or home nebulisers
Antibiotics if there is evidence of infection
What is the treatment for exacerbation of COPD if they have to go to hospital?
Nebulised bronchodilators (eg salbutamol 5mg/4h)
Steroids (200mg hydrocortisone)
Antibiotics if evidence of infection
Physiotherapy can help clear sputum
What is the next step of treatment in severe cases of COPD exacerbation who aren’t responding to first-line treatment?
IV aminophylline
Non-invasive ventillation
Intubation and ventilation with admission to intensive care
Doxapram can be used as a respiratory stimulant where NIV or intubation is not appropriate.
What does a SABA do?
short-acting adrenoreceptor acts as a bronchodilator in obstructive resp diseases.
What are the side effects of a SABA?
tremor, tachycardia, headache, palpitations, hypokalaemia
What is a SAMA?
short-acting muscarinic agonist, acts as a bronchodilator, in asthma and often in COPD
What are the side effects of a SAMA?
Arrhythmias, constipation, cough, dizziness, dry mouth, headache, nausea, GIT motility disorder.
What is a LABA?
long-acting beta agonist acts as a bronchodilator, often used un patients requiring long term therapy.
What are the side effects of LABA?
muscle cramps, dizziness, nausea, tremor, tachycardia, headache, palpitations, hypokalemia
What is a LAMA?
long-acting muscarinic antagonist acts as a bronchodilator, often used as a maintenance treatment of chronic obstructive pulmonary disease.
What are the limitations of a LAMA?
dry mouth, difficulties passing urine in men, arrhythmias, constipation, cough, dizziness, headache, nausea.
What is a prednisolone orally hydrocortisone IV beclometasone?
it is corticosteroids, used in exacerbation of COPD
