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504 (Immunology) > Chronic Obstructive Pulmonary Disease > Flashcards

Chronic Obstructive Pulmonary Disease Flashcards

1
Q

What is COPD

A

common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation usually caused by noxious particles

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2
Q

T/F: Most patients with COPD are old

A

False: 70% of patients are younger than 65

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3
Q

What is the most common chronic disease state concurrent with COPD

A

Cardiovascular Disease

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4
Q

What is the most modifiable risk factor for COPD,non-modfiable

A

Tobacco smoke, asthma

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5
Q

What are physical differences that patients with COPD have to deal with

A

Inflammation and excess mucus, breakdown of alveolar membranes

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6
Q

What are symptoms of COPD

A

chronic cough, progressive shortness of breath, sputum production

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7
Q

What test is required before a patient is diagnosed with COPD

A

Spirometry test

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8
Q

When a patient is taking a spirometry test what are the the values needed in order to diagnose for COPD

A

Forced expiratory volume in 1 second (FEV1), Forced vital capacity

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9
Q

When we have the needed parameters from spirometry how do we use them to know if a patient has COPD

A

FEV1/FVC =, If the value is less than 70% (.7) the patient will be diagnosed with COPD

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10
Q

Once the patient is diagnosed with COPD how is the level of severity assesed

A

FEV1 values

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11
Q

What percent will diagnose for Grade 1-4 in a patient with COPD

A

Grade 1 (mild): greater than 80%, Grade 2 (moderate): 50%-79%, Grade 3 (severe): 30%-49%, Grade 4 (very severe): less than 30%

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12
Q

What are COPD exacerbations

A

acute worsening or respiratory symptoms that result in additional therapy

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13
Q

How are mild exacerbation treated in patients with COPD

A

short acting beta-2-agonists only

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14
Q

How are moderate exacerbations treated in patients with COPD

A

short acting beta-2-agonists plus antibiotics and/or corticosteroids

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15
Q

How are severe exacerbations treated in patients with COPD

A

Hospitalizations with visits to the emergency room

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16
Q

What is the best treatment for COPD

A

Stop smoking

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17
Q

What are the nicotine replacement therapies

A

transdermal patches, gum, nasal spray, inhaler, lozenges

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18
Q

What the non-nicotine replacement therapies that need prescriptions

A

Bupropion SR and Varenicline

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19
Q

T/F: All smokers should recieve the pneumococcal 23 vaccine, if they are 65 or older than prevnar 13 first then one yearl later pneumococcal 23

A

True

20
Q

Why should patients COPD be up to date with flu shots and vaccines

A

The excess phlegm is a good breeding ground for infectious diseases

21
Q

What are two classes of medications that are short-acting bronchodilators

A

Short-acting beta-2-agonists, short-acting muscarinic antagonists

22
Q

What are two classes of medications that are long-acting bronchodilators

A

long-acting beta 2-agonists, long-acting muscarinic antagonsits

23
Q

What are the anti-inflammatory class of medications for COPD

A

inhaled corticosteroids, phosphodiesterase 4 inhibitors

24
Q

What are symptoms and exacerbations that would put a patient in group A for COPD

A

0 or 1 exacerbation that did not lead to hospital admission, mMRC of 0-1, CAT less than 10

25
Q

What are symptoms and exacerbations that would put a patient in group B for COPD

A

0 or 1 exacerbations that did not lead to hospital admission, mMRC greater than 2,CAT greater than 10

26
Q

What are symptoms and exacerbations that would put a patient in group C for COPD

A

Greater than 2 exacerbations or 1 or more that lead to hospital admission, mMRC of 0-1. CAT less than 10

27
Q

What are symptoms and exacerbations that would put a patient in group D for COPD

A

Greater than 2 exacerbations or 1 or more that lead to hospital admission, mMRC greater than 2, CAT greater than 10

28
Q

If a patient is group A what class of medication would they receive

A

any bronchodilator (short acting or long acting)

29
Q

If a patient is group B what class of medication would they receive

A

Long acting bronchodialators (LABA or LAMA)

30
Q

If a patient is Group C what class of medication would they receive

A

LAMA

31
Q

If a patient is Group D what class of medications would they recieve

A

Lama or LAMA plus LABA or ICS plus LABA

32
Q

What is the short acting muscarinic antagonist used in patients with COPD

A

Ipratropium

33
Q

What is the short-acting beta-2 agonist used in patients with COPD

A

Albuterol and Levalbuterol

34
Q

What is the short-acting bronchodilator combination medication

A

Combivent, Duoneb

35
Q

What are some side effects of using short-acting muscarinic antagonist

A

dry mouth, increased cardiovascular events, tachycardia

36
Q

What are some side effects of using short-acting beta-2 agonist

A

Increased heart rate and contraction, vasodilaitions, contractions, hypokalemia

37
Q

T/F: Combining short-acting agents produces a greater change in spirometry

A

True

38
Q

What are SABA and SAMA used for

A

Treat exacerbations and reduces symptoms

39
Q

What are the long-acting muscarinic antagonists used in COPD

A

tiotropium, aclidinium, umeclidinium, glycopyrrolate

40
Q

What is the gold standard for LAMAs used in COPD

A

Tiotropium

41
Q

What are side effects of LAMAs

A

dry mouth and blurred vision

42
Q

What are the gold standard class of medications that are used in COPD

A

LAMAs

43
Q

What are benefits of using LAMAs in COPD

A

reduce risk through prevention of exacerbations and hospitalizations, reduce symptoms

44
Q

T/F: None of the medications stop the decline in the loss of lung function or decrease mortality in COPD

A

True

45
Q

What are the long-acting beta-2 agonists used in COPD

A

Salmetrerol, Formoterol, Arfomoterol, Indacaterol, Olodaterol

46
Q

What are the side effects of using LABAs

A

tremors, insomnia, palpatations, tachycardia, hypokalemia

47
Q

What is the black box warning for talking LABAs

A

increased risk of asthma-related deaths if taken alone for asthma

504 (Immunology) (19 decks)

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