COPD

Question 1

emphysema vs bronchitis`

Answer 1

emphysema is destruction of the alveoli and bronchitis is inflammation of the bronchus

Question 2

who is at higher risk for developing COPD?

Answer 2

people with alpha-1 antitrypsin deficiency

Question 3

what is required to diagnose copd

Answer 3

spirometry: FEV1/FVC <0.7

Question 4

GOLD classes (1-4)

Answer 4

1: Mild, FEV1, greater than or equal to 80%
2: Moderate, FEV1 50-80%
3: Severe, FEV1 30-50%
4: Very severe, FEV1<30%

Question 5

scoring symptoms for COPD assessment

Answer 5

mMRC (assesses breathlessness) and CAT (COPD assessment test)

Question 6

what is 1st line for copd

Answer 6

a bronchodilator like a SABA, LABA, LAMA, or SAMA (PRN)

Question 7

difference between asthma and COPD

Answer 7

COPD - no ics monotherapy, can give LABA and lama together, theophylline not recommended, can use laba as monotherapy in COPD

Question 8

Recomended tx for each pt group

Answer 8

A) a bronchodilator (any…saba included)
B) LAMA/LABA
C) LAMA
D) C or may do more than one bronchodilator (LAMA + LABA) or may add on ICS to LABA if eos > 300

Question 9

atorvent

Answer 9

Ipatropium (SAMA) + albuterol

Question 10

atorvent cs combivent MDI

Answer 10

atorvent 2 inhalations 4x daily

combivent: 1 inhalation 4x daily

Question 11

combivent

Answer 11

ipatropium + albuterol (LAMA + SABA)

Question 12

spiriva DPI vs MDI

Answer 12

tiotropium (LAMA)

DPI 1 capsule daily (2 puffs) and MDI is 2 inhalations daily

Question 13

handihaler and neohaler

Answer 13

dips that come with a capsule

Question 14

side effects of a lama

Answer 14

dry mouth (anticholinergic)

Question 15

if exacerbations tx

Answer 15

add up to 3 drugs (may consider lama + laba + ICS)

Question 16

lama vs SAMA dosing

Answer 16

LAMA (2 puffs daily), SAMA 1-2 puffs 4x daily

Question 17

how to use to use respimat

Answer 17

T - turn
O - open
P - press

Question 18

how to use handihalet

Answer 18

insert into capsule, press green button, breathe in deeply and fully to hear rattling and breathe in twice

Question 19

neohaler

Answer 19

capsule in cover, check to see if capsule empthy

Question 20

roflumilast

Answer 20

pde4 inhibitor

Question 21

roflumilast moa and contraindication and side effects

Answer 21

a PDE-4 inhibitor that reduces lung inflammation, contraindicated in lover failure and can lead to diarhea and weigtht loss

Question 22

combo inhalers that contain formeterol and therofore can be used PRN for ashma

Answer 22

DUlera (mometasone + formeterol) and symbicort (budosenide + formeterol)

Question 23

advair

Answer 23

fluticasone + salmeterol (ICS + laba) ** not for rescue