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Integrated Pharmaceutical and Patient Care 1 (IPPC1) > Case Study 1- Chronic Obstructive Pulmonary Disease (COPD) > Flashcards

Case Study 1- Chronic Obstructive Pulmonary Disease (COPD) Flashcards

1
Q

What is COPD?

A

Long term obstruction of the airways due to own muscle obstruction

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2
Q

What is chronic bronchitis?

A

Inflammation and excess mucous in the airways

Airflow limitation

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3
Q

What is emphysema distraction?

A

Parts of the lungs involving gas exchange such as the alveolar membrane breakdown

Causing breaking difficulties and shortness of breath

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4
Q

What are the symptoms of COPD?

A

Chronic productive cough

Persistent and productive breathlessness

Shortness of breath (dyspnea)

Excess sputum production

Persistent wheezing

Chest infections

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5
Q

How is COPD diagnosed?

A

Spirometry- where the FEV/FVC ratio is less that 0.7

Blood test: alpha-1-antitrypsin deficiency

Chest x-ray: lung cancer and chest infection

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6
Q

What is the aims of treatment

A
  • reduce risk of exacerbation/ frequency of symptoms
  • improve exercise tolerance

-improve quality of life

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7
Q

What is the initial (1st line) treatment for COPD?

A

Offer SABA or SAMA

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8
Q

What is the mechanism of action of a SABA and LABA ?

A

They’re beta-2-agonists

Therefore:

  1. Binds to beta 2 receptors in the smooth muscle
  2. This causes smooth muscle relaxation
  3. Which causes airways dilation
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9
Q

What are the common side effects associated with beta-2-agonists?

A

Tremors
Palpitations
Headache
Anxiety
Insomnia

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10
Q

What is the mechanism of action of a SAMA and LAMA?

A

They’re muscurinic antagonists

Therefore:

  1. Bind to M3 receptors in the smooth muscle
  2. This inhibits ACh from acting in the desert of
  3. ACh is responsible for the muscle constriction of smooth muscles
  4. Therefore blocking the receptor will reduce muscle constriction causing smooth muscle relaxation
  5. Opening up the airways
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11
Q

What are the common side effects of muscurinic antagonists?

A

Dry mouth
Constipation
Blurred vision
Tachycardia
Drowsiness
Urinary retention

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12
Q

What is the mechanism of action of ICS?

A

Binds to glucocorticoid receptors in the lungs

This reduces inflammation

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13
Q

Give an example of a Saba

A

Salbutamol

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14
Q

Give an example of a LABA

A

Tiotropium

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15
Q

Give an example of a LAMa

A

Salmeterol
Formeterol

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16
Q

Give an example of a SAMA

A

Iprotropium

17
Q

Give an example of an ICS

A

Fostair

18
Q

What lifestyle advice can be given to COPD patients

A

Exercise
Balanced diet to reduce risk of infection
Smoking cessation
Online resources and support groups
Vaccination

19
Q

What if FVC?

A

Total amount of air yoy can breath out after taking a deep breath

20
Q

What is FEV1?

A

The total amount of air breathed out after a second

21
Q

When would an ICS be prescribed to a patient with COPD?

A

When SABA or SAMA has been prescribed and not managing symptoms effectively

If asthmatic feature or features suggestive steroid responsiveness are present

Consider an ICS

22
Q

When should oral corticosteroids be used in COPD? Give an example of a corticosteroid used and it’s doses

A

When there is an exacerbation of COPD

Prednisolone 30mg daily for 5 days

23
Q

When would we use antibiotics to treat COPD?

A

If there is a COPD exacerbation caused by a chest infection

24
Q

What are the side effects associated with oral corticosteroids?

A

Increase appetite
Increases risk of infection (pneumonia)
Osteoporosis
Blood glucose effected

25
Q

How can we identify anxiety and depression in patients with COPD?

A

Have severe breathlessness
Are hypoxia
Have been seen at or admitted to hospital with an exacerbation of COPD

In the the NICE guidelines

26
Q

When are nebulisers used in COPD?

A

When there is an exacerbation of COPD

27
Q

When should oral prednisone be given in patients with COPD?

A

When there is an exacerbation

Where there is an increased breathlessness that interfere with daily activities

28
Q

What dose of salbutamol should be given in a oxygen driven nebuliser?

A

5mg given every 20-30mins or when required

Ventolin nebules given salbutamol sulfate per 1mg per 1ml

Integrated Pharmaceutical and Patient Care 1 (IPPC1) (24 decks)

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