Chronic Obstructive Pulmonary Disease Flashcards
What is COPD
common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation usually caused by noxious particles
T/F: Most patients with COPD are old
False: 70% of patients are younger than 65
What is the most common chronic disease state concurrent with COPD
Cardiovascular Disease
What is the most modifiable risk factor for COPD,non-modfiable
Tobacco smoke, asthma
What are physical differences that patients with COPD have to deal with
Inflammation and excess mucus, breakdown of alveolar membranes
What are symptoms of COPD
chronic cough, progressive shortness of breath, sputum production
What test is required before a patient is diagnosed with COPD
Spirometry test
When a patient is taking a spirometry test what are the the values needed in order to diagnose for COPD
Forced expiratory volume in 1 second (FEV1), Forced vital capacity
When we have the needed parapmeters from spirometry how do we use them to know if a patient has COPD
FEV1/FVC =, If the value is less than .7 the patient will be diagnosed with COPD
Once the patient is diagnosed with COPD how is the level of severity assesed
FEV1 values
What percent will diagnose for Grade 1-4 in a patient with COPD
Grade 1 (mild): greater than 80%, Grade 2 (moderate): 50%-79%, Grade 3 (severe): 30%-49%, Grade 4 (very severe): less than 30%
What are COPD exacerbations
acute worsening or respiratory symptoms that result in additional therapy
How are mild exacerbation treated in patients with COPD
short acting beta-2-agonists only
How are moderate exacerbations treated in patients with COPD
short acting beta-2-agonists plus antibiotics and/or corticosteroids
How are severe exacerbations treated in patients with COPD
Hospitalizations with visits to the emergency room
What is the best treatment for COPD
Stop smoking
What are the nicotine replacement therapies
transdermal patches, gum, nasal spray, inhaler, lozenges
What the non-nicotine replacement therapies that need prescriptions
Bupropion SR and Varenicline
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
True
Why should patients COPD be up to date with flu shots and vaccines
The excess phlegm is a good breeding ground for infectious diseases
What are two classes of medications that are short-acting bronchodilators
Short-acting beta-2-agonists, short-acting muscarinic antagonists
What are two classes of medications that are long-acting bronchodilators
long-acting beta 2-agonists, long-acting muscarinic antagonsits
What are the anti-inflammatory class of medications for COPD
inhaled corticosteroids, phosphodiesterase 4 inhibitors
What are symptoms and exacerbations that would put a patient in group A for COPD
0 or 1 exacerbation that did not lead to hospital admission, mMRC of 0-1, CAT less than 10
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
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
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
If a patient is group A what class of medication would they receive
any bronchodilator (short acting or long acting)
If a patient is group B what class of medication would they receive
Long acting bronchodialators (LABA or LAMA)
If a patient is Group C what class of medication would they receive
LAMA
If a patient is Group D what class of medications would they recieve
Lama or LAMA plus LABA or ICS plus LABA
What is the short acting muscarinic antagonist used in patients with COPD
Ipratropium
What is the short-acting beta-2 agonist used in patients with COPD
Albuterol and Levalbuterol
What is the short-acting bronchodilator combination medication
Combivent, Duoneb
What are some side effects of using short-acting muscarinic antagonist
dry mouth, increased cardiovascular events, tachycardia
What are some side effects of using short-acting beta-2 agonist
Increased heart rate and contraction, vasodilaitions, contractions, hypokalemia
T/F: Combining short-acting agents produces a greater change in spirometry
True
What are SABA and SAMA used for
Treat exacerbations and reduces symptoms
What are the long-acting muscarinic antagonists used in COPD
tiotropium, aclidinium, umeclidinium, glycopyrrolate
What is the gold standard for LAMAs used in COPD
Tiotropium
What are side effects of LAMAs
dry mouth and blurred vision
What are the gold standard class of medications that are used in COPD
LAMAs
What are benefits of using LAMAs in COPD
reduce risk through prevention of exacerbations and hospitalizations, reduce symptoms
T/F: None of the medications stop the decline in the loss of lung function or decrease mortality in COPD
True
What are the long-acting beta-2 agonists used in COPD
Salmetrerol, Formoterol, Arfomoterol, Indacaterol, Olodaterol
What are the side effects of using LABAs
tremors, insomnia, palpatations, tachycardia, hypokalemia
What is the black box warning for talking LABAs
increased risk of asthma-related deaths if taken alone for asthma
