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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T/F: Most patients with COPD are old

A

False: 70% of patients are younger than 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common chronic disease state concurrent with COPD

A

Cardiovascular Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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

A

Tobacco smoke, asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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

A

Inflammation and excess mucus, breakdown of alveolar membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are symptoms of COPD

A

chronic cough, progressive shortness of breath, sputum production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What test is required before a patient is diagnosed with COPD

A

Spirometry test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

FEV1 values

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are COPD exacerbations

A

acute worsening or respiratory symptoms that result in additional therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are mild exacerbation treated in patients with COPD

A

short acting beta-2-agonists only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How are moderate exacerbations treated in patients with COPD

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are severe exacerbations treated in patients with COPD

A

Hospitalizations with visits to the emergency room

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the best treatment for COPD

A

Stop smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the nicotine replacement therapies

A

transdermal patches, gum, nasal spray, inhaler, lozenges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What the non-nicotine replacement therapies that need prescriptions

A

Bupropion SR and Varenicline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

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
What are symptoms and exacerbations that would put a patient in group B for COPD
0 or 1 exacerbations that did not lead to hospital admission, mMRC greater than 2,CAT greater than 10
26
What are symptoms and exacerbations that would put a patient in group C for COPD
Greater than 2 exacerbations or 1 or more that lead to hospital admission, mMRC of 0-1. CAT less than 10
27
What are symptoms and exacerbations that would put a patient in group D for COPD
Greater than 2 exacerbations or 1 or more that lead to hospital admission, mMRC greater than 2, CAT greater than 10
28
If a patient is group A what class of medication would they receive
any bronchodilator (short acting or long acting)
29
If a patient is group B what class of medication would they receive
Long acting bronchodialators (LABA or LAMA)
30
If a patient is Group C what class of medication would they receive
LAMA
31
If a patient is Group D what class of medications would they recieve
Lama or LAMA plus LABA or ICS plus LABA
32
What is the short acting muscarinic antagonist used in patients with COPD
Ipratropium
33
What is the short-acting beta-2 agonist used in patients with COPD
Albuterol and Levalbuterol
34
What is the short-acting bronchodilator combination medication
Combivent, Duoneb
35
What are some side effects of using short-acting muscarinic antagonist
dry mouth, increased cardiovascular events, tachycardia
36
What are some side effects of using short-acting beta-2 agonist
Increased heart rate and contraction, vasodilaitions, contractions, hypokalemia
37
T/F: Combining short-acting agents produces a greater change in spirometry
True
38
What are SABA and SAMA used for
Treat exacerbations and reduces symptoms
39
What are the long-acting muscarinic antagonists used in COPD
tiotropium, aclidinium, umeclidinium, glycopyrrolate
40
What is the gold standard for LAMAs used in COPD
Tiotropium
41
What are side effects of LAMAs
dry mouth and blurred vision
42
What are the gold standard class of medications that are used in COPD
LAMAs
43
What are benefits of using LAMAs in COPD
reduce risk through prevention of exacerbations and hospitalizations, reduce symptoms
44
T/F: None of the medications stop the decline in the loss of lung function or decrease mortality in COPD
True
45
What are the long-acting beta-2 agonists used in COPD
Salmetrerol, Formoterol, Arfomoterol, Indacaterol, Olodaterol
46
What are the side effects of using LABAs
tremors, insomnia, palpatations, tachycardia, hypokalemia
47
What is the black box warning for talking LABAs
increased risk of asthma-related deaths if taken alone for asthma