Chapter 42: COPD Flashcards

1
Q

What is emphysema

A

destruction of the alveoli

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2
Q

People with ____ deficiency are at higher risk of developing COPD

A

alpha-1 antitrypsin (AAT)

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3
Q

What is required to make a diagnosis of COPD

A

Spirometry

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4
Q

A post-bronchodilator FEV1/FVC < __ confirms a diagnosis of COPD

A

0.7

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5
Q

First-line treatment for COPD

A

bronchodilators

two bronchodilators is generally preferred, i.e., LAMA + LABA

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6
Q

the mMRC dyspnea scale assesses

A

breathlessness

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7
Q

Which vaccinations should a person with COPD get

A

Influenza and pneumococcal

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8
Q

Long term monotherapy with an oral steroid or ICS if not recommended in COPD, but an ICS can be added to a LAMA or LAMA + LABA in select patients with past exacerbations and high ____

A

high eosinophil count (a marker of inflammation)

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9
Q

Initial pharmacologic therapy using ABCD assessment for COPD

A

A - Bronchodilator: SABA or SAMA PRN, LABA or LAMA
B - LAMA or LABA
C- LAMA
D - LAMA or LAMA + LABA

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10
Q

In COPD exacerbations, if there is increased sputum production, increased sputum volume, increased dyspnea or if mechanical ventilation is required, what should be used

A

antibiotics

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11
Q

Ipratropium bromide brand name

Ipratropium + albuterol brand name

A

Atrovent HFA
(-atro is in ipratropium)

Combivent Respimat

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12
Q

Ipratropium bromide dosing

A

MDI: 2 inhalations QID

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13
Q

Combivent Respimat dosing

A

MDI: 1 inhalation QID

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14
Q

Tiotropium brand names

A

Spiriva HandiHaler

Spiriva Respimat

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15
Q

Tiotropium dosing for MDI and DPI

A

DPI: 1 capsule via HandiHaler device daily (requires 2 puffs)
MDI: 2 inhalations daily

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16
Q

SE of SAMAs and LAMAs

A

Dry mouth

17
Q

Which DPI devices come with a capsule to put inside the device

A

HandiHaler and Neohaler

18
Q

Salmeterol + fluticasone brand name

A

Advair Diskus

19
Q

Formoterol + budesonide brand name

A

Symbicort

20
Q

Vilanterol + fluticasone brand name

A

Breo Ellipta

21
Q

LABA SE

A

Nervousness, tremor, tachycardia, palpitations, hyperglycemia, ↓ K

22
Q

Arformoterol contains the __ isomer of formoterol

A

R

23
Q

Which drug is a PDE-4 inhibitor that increases CAMP levels, leading to reduction in lung inflammation

A

Roflumilast

24
Q

Roflumilast CI

A

moderate to severe liver impairment

25
Q

Roflumilast SE

A

diarrhea, weight loss

26
Q

Which MDI does NOT need to be shaken before using

A

Atrovent HFA (Ipratropium bromide)

27
Q

When using ____, make sure to keep your eyes closed so that no medication will be sprayed into your eyes

A

Atrovent HFA (Ipratropium bromide)

28
Q

Counseling for Respimat products

A

REMEMBER: TOP
Turn the clear base
Open the cap and close lips around mouthpiece
Press the dose release button and inhale

29
Q

How should Respimat products be cleaned

A

with a damp cloth or tissue weekly

30
Q

How to get the full dose from Spiriva HandiHaler

A

must inhaler twice from each capsule

31
Q

How to know if the dose is ready when using Tudorza Pressair

A

If the control window is changed from red to green (turns back to red when the dose has been inhaled correctly)