COPD Flashcards
diagnosis of COPD
smoking more than 10 years
sputum production
non allergic symptoms
symptoms are persistent
disease worsens overtime
excerbation
spirometry test to measure FVC and FEV
FEV1/FVC <0.7 is positive for COPD
GOLD 1
mild
FEV>80
GOLD 2
moderate
FEV between 50-80%
GOLD 3
severe
FEV between 30-50
GOLD 4
Very Severe
FEV <30%
WHat are some tests to determine symptoms severity
CAT- COPD assessment test
Dyspnea scale
What is ABCD
more like CDAB
drug treatment for COPD
bronchodilators 1st line with
SABA
SAMA
** long term oral mono therapy is not recommended
** ICS for pt with high eosinophil count
Group A pts treatment
SABA/SAMA prn
LABA or LAMA
group B tx
LAMA / LABA
group C
LAMA
group D tx
LAMA
LAMA plus LABA
LABA plus ICS
escalation of tx
if dyspnea starrt with LAMA add LABA/LAMA
if exacerbation LAMA/LABA + LABA?LAMA or LABA ICS
refer to pg 599
is mono therapy with oral steroid or iCS recommended
NOPE
when is ICS added on
Hihg esonophils
last line of tx after LABA LAMA ICS
azithro/ roflimilast
which class of broncho dilators are good for exhacerbations
LAMA
what are some SAMA
iprotopiunm - Atrovent +albuterol, combivent
what are some LAMA
tiotropium- spiriva, aclemdium, umeclidinium (incruse)
what are some notes on Muscuranic antagonist
dry mouth
handinhaler comes with a capsule for inserting not taking orally
LABA
salmeterol +fluticasone (advair)
formoterol + budesonide (symbicort
vilanterol +fluticasone (breo ellipta)
what is only available in combination
Vilanterol
what are some notes on long acting beta 2 agonist
tremor,
tachy cardia,
palpitation,
hyperglycemia
hypokalmeia
MOA of SAMA/LAMA
bronchodilation by blocking ach contriction at M3 bronchial smooht muscle
MOA of LABA
relaxation of bronchoil smooth m,uske
what are some notes on ICS
after use rinse mouth with water and spit to avoid oral candidiasis
counselling metered dose inhaler like Atrovent HFA
do not shake
spray 2 times and prime again in >3 days
clean weekly removing metal cannister with warm water running 30 sec
keep eyes closed when using
breath slowly and deeply through mouth
what are resimat products
albuterol/ipotropium =combivent
oldaterol/tiotropium
oldaterol
tiotropium
counselling on resimat prducts
TOP
Turn- with cap closed until clicks
open- cap until it snaps fully, breathe out slowly and fully
press- while breathing in slowly and deeply
prime- point towards the ground and press until spray is visible then 3 more times
clean with damp cloth weekly
tiotropium counseling dry powder inhalers handhaler
do not need to prime
clean as needed with running water let air dry
open insert green button inhale twice
aclidium tudorza pressair
remove protective cap pulling the arrow
press green button all the way down
control window should turn from red to green
breathe out
breathe in quickly and deeply until click sound
breathe out
cehck control should turn red
ellipta products
open cover
breath fully out
inhale do not block airvent
rinse mouth for ICS products
