Treatment of COPD

Question 1

clinical use of B2 agonists for COPD

Answer 1

used as ICS/ LABA combo or LAMA/ LABA combo or ICS/ LABA/ LAMA combo

Question 2

clinical use of muscarinic antagonists

Answer 2

These block end-plate M3 receptors
Inhaled route only
used mostly in COPD to reduce exacerbations

Question 3

Methylxanthines

Answer 3

these are non-selective PDE inhibitors, so promote bronchodilation. They also act as adenosine antagonists (when adenosine binds to mast cells: mast cells release histamine)

Question 4

PDE4 inhibitors

Answer 4

these reduce exacerbations, and are additive to LABA/ LAMA
has adverse effects (nausea, diarrhoea, weight loss, headache)
rarely used
they are add ons to LABA/LAMA in frequent exacerbations instead of ICS

Question 5

mucolytics

Answer 5

these reduce sputum viscosity and aid sputum expectoration

rarely used, and only used as add-on to other treatments

Question 6

non-pharmacological managements of COPD

Answer 6

-smoking cessation
-immunisation (flu, pneumococcal)
physical activity
-venesection
-oxygen