COPD Flashcards

1
Q

diagnosis of COPD

A

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

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

GOLD 1

A

mild
FEV>80

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

GOLD 2

A

moderate
FEV between 50-80%

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

GOLD 3

A

severe
FEV between 30-50

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

GOLD 4

A

Very Severe
FEV <30%

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

WHat are some tests to determine symptoms severity

A

CAT- COPD assessment test
Dyspnea scale

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

What is ABCD

A

more like CDAB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

drug treatment for COPD

A

bronchodilators 1st line with
SABA
SAMA
** long term oral mono therapy is not recommended
** ICS for pt with high eosinophil count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Group A pts treatment

A

SABA/SAMA prn
LABA or LAMA

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

group B tx

A

LAMA / LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

group C

A

LAMA

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

group D tx

A

LAMA
LAMA plus LABA
LABA plus ICS

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

escalation of tx

A

if dyspnea starrt with LAMA add LABA/LAMA
if exacerbation LAMA/LABA + LABA?LAMA or LABA ICS

refer to pg 599

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

is mono therapy with oral steroid or iCS recommended

A

NOPE

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

when is ICS added on

A

Hihg esonophils

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

last line of tx after LABA LAMA ICS

A

azithro/ roflimilast

17
Q

which class of broncho dilators are good for exhacerbations

18
Q

what are some SAMA

A

iprotopiunm - Atrovent +albuterol, combivent

19
Q

what are some LAMA

A

tiotropium- spiriva, aclemdium, umeclidinium (incruse)

20
Q

what are some notes on Muscuranic antagonist

A

dry mouth
handinhaler comes with a capsule for inserting not taking orally

21
Q

LABA

A

salmeterol +fluticasone (advair)
formoterol + budesonide (symbicort
vilanterol +fluticasone (breo ellipta)

22
Q

what is only available in combination

A

Vilanterol

23
Q

what are some notes on long acting beta 2 agonist

A

tremor,
tachy cardia,
palpitation,
hyperglycemia
hypokalmeia

24
Q

MOA of SAMA/LAMA

A

bronchodilation by blocking ach contriction at M3 bronchial smooht muscle

25
MOA of LABA
relaxation of bronchoil smooth m,uske
26
what are some notes on ICS
after use rinse mouth with water and spit to avoid oral candidiasis
27
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
28
what are resimat products
albuterol/ipotropium =combivent oldaterol/tiotropium oldaterol tiotropium
29
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
30
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
31
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
32
ellipta products
open cover breath fully out inhale do not block airvent rinse mouth for ICS products