Chapter 42: COPD Flashcards
What is emphysema
destruction of the alveoli
People with ____ deficiency are at higher risk of developing COPD
alpha-1 antitrypsin (AAT)
What is required to make a diagnosis of COPD
Spirometry
A post-bronchodilator FEV1/FVC < __ confirms a diagnosis of COPD
0.7
First-line treatment for COPD
bronchodilators
two bronchodilators is generally preferred, i.e., LAMA + LABA
the mMRC dyspnea scale assesses
breathlessness
Which vaccinations should a person with COPD get
Influenza and pneumococcal
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 ____
high eosinophil count (a marker of inflammation)
Initial pharmacologic therapy using ABCD assessment for COPD
A - Bronchodilator: SABA or SAMA PRN, LABA or LAMA
B - LAMA or LABA
C- LAMA
D - LAMA or LAMA + LABA
In COPD exacerbations, if there is increased sputum production, increased sputum volume, increased dyspnea or if mechanical ventilation is required, what should be used
antibiotics
Ipratropium bromide brand name
Ipratropium + albuterol brand name
Atrovent HFA
(-atro is in ipratropium)
Combivent Respimat
Ipratropium bromide dosing
MDI: 2 inhalations QID
Combivent Respimat dosing
MDI: 1 inhalation QID
Tiotropium brand names
Spiriva HandiHaler
Spiriva Respimat
Tiotropium dosing for MDI and DPI
DPI: 1 capsule via HandiHaler device daily (requires 2 puffs)
MDI: 2 inhalations daily
SE of SAMAs and LAMAs
Dry mouth
Which DPI devices come with a capsule to put inside the device
HandiHaler and Neohaler
Salmeterol + fluticasone brand name
Advair Diskus
Formoterol + budesonide brand name
Symbicort
Vilanterol + fluticasone brand name
Breo Ellipta
LABA SE
Nervousness, tremor, tachycardia, palpitations, hyperglycemia, ↓ K
Arformoterol contains the __ isomer of formoterol
R
Which drug is a PDE-4 inhibitor that increases CAMP levels, leading to reduction in lung inflammation
Roflumilast
Roflumilast CI
moderate to severe liver impairment
Roflumilast SE
diarrhea, weight loss
Which MDI does NOT need to be shaken before using
Atrovent HFA (Ipratropium bromide)
When using ____, make sure to keep your eyes closed so that no medication will be sprayed into your eyes
Atrovent HFA (Ipratropium bromide)
Counseling for Respimat products
REMEMBER: TOP
Turn the clear base
Open the cap and close lips around mouthpiece
Press the dose release button and inhale
How should Respimat products be cleaned
with a damp cloth or tissue weekly
How to get the full dose from Spiriva HandiHaler
must inhaler twice from each capsule
How to know if the dose is ready when using Tudorza Pressair
If the control window is changed from red to green (turns back to red when the dose has been inhaled correctly)
