00 Chronic Obstructive Pulmonary Disease (COPD)

Question 1

What is the definition of Chronic Bronchitis?

Answer 1

Inflammatory response in the larger airways which consists of CHRONIC COUGH AND SPUTUM PRODUCTION for most days out of 3 months in at least 2 consecutive years

Question 2

What are the symptoms of Chronic Bronchitis?

Answer 2

Productive cough. “Blue bloaters”. Usually overweight

Question 3

What is the definition of Emphysema?

Answer 3

IRREVERSIBLE ENLARGEMENT OF AIRSPACES distal to terminal bronchioles, ALVEOLAR WALL DESTRUCTION, airflow obstruction. Reduction of surface area for gas exchange

Question 4

What are the symptoms of Emphysema?

Answer 4

Minimal cough. “Pink puffers”. Usually thin. Dyspnea, even at rest

Question 5

Which vaccines are recommended for patients with COPD?

Answer 5

Influenza vaccine annually. Pneumococcal vaccine (CDC recommends for < 65 with chronic lung disease (COPD, emphysema, asthma) and all patients 65+

Question 6

What are the two main pharmacologic choices for COPD?

Answer 6

Bronchodilator (SABA/LABA, anticholinergics, theophylline, combination of these drugs). Steroids

Question 7

What is the recommended treatment for Stage I: Mild COPD?

Answer 7

SABA or SAMA prn

Question 8

What is the recommended treatment for Stage II Moderate COPD?

Answer 8

LABA or LAMA

Question 9

What is the recommended treatment for Stage III Severe COPD?

Answer 9

ICA + LABA or LAMA

Question 10

What is the recommended treatment for Stage IV Very Severe COPD?

Answer 10

ICS + LABA and/or LAMA + Long-term oxygen therapy if chronic respiratory failure, consider surgical procedure

Question 11

What is the generic name of Daliresp?

Answer 11

Roflumilast (PDE-4 Inhibitor) - reduces inflammation by inhibiting breakdown of intracellular cyclic AMP and cGMP