Phar 720 Asthma & COPD Flashcards

1
Q

Short Acting Beta-2 Agonists (SABA) (inhalation)

A

Albuterol (pro air, ventolin, proventil)

Levalbuterol (xopenex)

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2
Q

Albuterol

A

Proair, ventolin, proventil
Used for asthma, COPD
Usually 1-2 puffs q 4 to 6h prn
Side effects: inc in heart rate possible shakiness, throat irritation

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3
Q

Levalbuterol

A

Xopenex

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4
Q

Long Acting Beta-2 Agonists (LABA)

A

Salmeterol (serevent)

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5
Q

Salmeterol

A

Serevent

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6
Q

Corticosteroids (inhalation)

A

Fluticasone (Flovent)

Budesonide (pulmicort)

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7
Q

Fluticasone

A

Flovent

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8
Q

Budesonide

A

Pulmicort

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9
Q

Corticosteroid/LABA’s (inhalation)

A

Fluticasone/Salmeterol (advair)
Budesonide/formoterol (symbicort)
Mometasone/formoterol (Dulera)

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10
Q

Fluticasone/Salmeterol

A

Advair

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11
Q

Budesonide/formoterol

A

Symbicort

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12
Q

Mometasone/formoterol

A

Dulera

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13
Q

Anticholinergics (inhalation)

A

Tiotropium (spiriva)

Ipatropium (atrovent)

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14
Q

Tiotropium

A

Spiriva

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15
Q

Ipatropium

A

Atrovent

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16
Q

Anticholinergic/Beta-2 Agonists (inhalation)

A

Ipatropium/Albuterol (combivent)

Umeclidinium/vilanterol (anoro ellipta)

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17
Q

Ipatropium/Albuterol

A

Combivent

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18
Q

Umeclidinium/vilanterol

A

Anoro ellipta

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19
Q

Anticholinergic/Beta-2 agonists/corticosteroid (inhalation)

A

Umeclidinium/vilanterol/Fluticasone (trelegy)

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20
Q

Umeclidinium/vilanterol/Fluticasone

A

Trelegy

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21
Q

Name COPD

A

Chronic obstructive pulmonary disease

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22
Q

Name PEF

A

Peak expiratory flow

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23
Q

FEV1

A

Forced expiratory volume at 1 second

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24
Q

FVC

A

Forced vital capacity

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25
Q

SABA

A

Short acting beta2 agonist

26
Q

LABA

A

Long acting beta2 agonist

27
Q

LAMA

A

Long acting muscarinic agonist

28
Q

SAMA

A

Short acting muscarinic agonist

29
Q

ICS

A

Inhaled corticosteroid

30
Q

Define asthma

A

Inflammation and bronchoconstriction of lungs (narrows airway)

31
Q

Atopic asthma

A

Allergen sensitization
Most common
Positive family history
IgE meditated: elevation of immunoglobulin E

32
Q

Non-atopic asthma

A

Non allergic

Positive family history less common

33
Q

Exercised induced bronchoconstriction

A

Type of asthma, worsens in cold and dry climate

34
Q

Drug induced asthma

A

Inhibit cyclooxygenase pathway (aspirin, NSAID’s are common triggers)

35
Q

Occupational asthma

A

Exposure to fumes, chemical dusts

36
Q

Risk factors for asthma

A

Allergies=>IgE mediated response to common allergens
Viral infections=> can trigger an inflammatory response
Eczema=> inflammation of skin can spread to lungs
Occupational exposures
Obesity=> fat is involved in inflammatory pathways
Family history
Air pollution

37
Q

Common Asthma Triggers

A
Genetics
Pollution
Cigarettes
Perfumes and cosmetics
Cold air/changes in weather
Pets
Dust, pollen and cockroaches
Drugs, aspirin, NSAIDS
38
Q

Symptoms of asthma

A

Wheezing
Shortness of breath
Cough
Chest tightness

39
Q

Signs of asthma

A

Decreased peak expiratory flow (PEF)=> lung function
Increased heart rate
Increased respiratory rate
Low blood pressure

40
Q

Pulmonary function tests

A

Spirometry: device to test lung function
FEV1: how much air can be forcefully exhaled in one sec
FVC: after taking a deep breath, the maximum volume of air that is exhaled
FEV1/FVC: percentage of total air capacity that can be forcefully exhaled in one sec

41
Q

What are the 2 types of asthma drugs

A

Relievers/rescue drugs: rapidly open airways within minutes

Controllers/maintenance drugs: taken daily to reduce inflammation, maintain asthma control

42
Q

What rescue meds are the first line of treatment?

A

SABA: relax bronchial smooth muscle in 3-5 min
LABA: inhibit inflamm. Response,block reactions to allergens, reduce airway hyperresponsiveness
*ICS+ formoterol can be used as a reliever or for maintenance
Anticholinergic: block parasympathetic nerve reflexes which cause airway constriction
*usually used with SABA

43
Q

Controller meds for asthma

A

Inhaled corticosteroids (ICS):anti-inflammatory
LABA: Used in combo with ICS *never used alone
ICS+formoterol can be used as reliever or maintenance
Leukotrine receptor antagonist (LTRA): targets one of the inflammatory pathways

44
Q

Additional/last resort therapies

A

Long acting muscarinic antagonists (LAMA): used as an add on in pts w/ a history of exacerbations despite’s ICS/LABA treatment
Anti-IgE: for severe allergic asthma uncontrolled by ICS/LABA *only used in a healthcare setting under supervision
Methylxanthine: alternative bronchodilator when not responding to other treatments

45
Q

Ex. Of Anti-IgE med

A

Omalizumab (injection)

46
Q

Ex. Of Methylxanthine med

A

Theophylline

47
Q

What does GINA stand for and what is it?

A

Global initiative for asthma guidelines. It is a resource for guiding the start of treatments from assessments of a pt

48
Q

What is COPD

A

Causes obstructive airflow to lungs
Most commonly due to chronic bronchitis and/or emphysema
It is chronic and irreversible

49
Q

Bronchitis

A

Inflammation and excess mucus in the bronchioles

50
Q

Emphysema

A

Alveolar sacs become destroyed. Creates a lack of exchange of oxygen

51
Q

1 cause o COPD?

A

Cigarette smoke

52
Q

COPD risk factors

A
Tobacco smoke
Alpha-1 antitrypsin (ATT) deficiency: protein made in liver to protect lungs from inflammation
Asthma: can lead to COPD
Exposure to particles
Older age
Socioeconomic status
53
Q

Symptoms of COPD

A

Coughing/wheezing
Excess phlegm,mucus, or sputum production
SOB
Trouble with deep breaths

54
Q

Signs of COPD

A

Decline in PEF and FEV1 (FEV1/FVC < 0.7 confirms diagnosis)
Inc. heart rate & resp. Rate
Pulmonary hypertension
Signs of right sided heart failure
Pursed lip breathing
Lips or fingernails are blue or gray in color

55
Q

What is GOLD guidelines

A

Global initiative for chronic obstructive lung disease guidelines
Classifies and assesses COPD to direct treatment

56
Q

*** Go over guidelines assessment tool

A

Yes sir

57
Q

Define displeasure

A

SOB

58
Q

What is mMRC used to do?

A

Assesses breathlessness => a survey pts fill out

59
Q

What is CAT?

A

Assess impact of COPD on pt health, a form pt fills out

60
Q

COPD vs. Asthma

A

Age of onset: COPD over 40, asthma under 40
Smoking history: COPD over 10 years, asthma uncommon
Sputum production: COPD more common, asthma less common
Allergies: COPD uncommon, asthma common
Disease process: COPD progressive, worsens over time, asthma stable, does not worsen overtime
Exacerbations: COPD common complication, asthma common complication
Preferred medication: COPD LAMA,asthma corticosteroids