COPD Flashcards by Hannah Lapos

How does COPD differ from asthma

COPD
1. Neutrophillic
2. LTB4, IL8, and TNFa
3. Squamous metaplasia of epithelium
4. Parenchymal destruction
5. GC have variable effect

Asthma
1. Eosinophilic
2. LTD4, IL4, IL5, others
3. Fragile epithelium
4. Thickening of basement membrane
5. GC inhibit inflammation

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What are the symptoms of COPD?

Chronic cough
Sputum production
Dyspnea
A1at deficiency

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What are the physical examination of COPD?

Cyanosis
Barrel chest
Shallow breathing
Pursed lips
Use accessory respiratory muscles

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What are diagnosis tests for COPD?

Spirometry
X ray
Arterial blood bas

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What are the risk factors for COPD?

Tobacco smoke

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What is GOLD 1?

FEV1/FVC < 70%
FEV1 ≥80%
With or without symptoms

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What is GOLD 2?

FEV1/FVC < 70%
FEV1: 50-79%

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What is GOLD 3?

FEV1/FVC: <70
FEV1: 30-49

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What is GOLD 4?

FEV1/FVC <70%
FEV1: <30%

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What are the nonpharm therapy of COPD?

End of life plans
Palliative care (morphine and lorazepam)
Smoking cessation
Light excersise

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What are immunizations ok for COPD?

Annual flu vaccine
Pneumococcal polysaccharide
Shingrex
COVID

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What is Group A?

SABDs PRN

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What is group B?

LABDs with group A regimen

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What is group e?

ICS-LABDs added to group B

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What are the bronchodilators for COPD?

Beta agonist
Anticholingergics
Methlxanthines

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What route of med is preferred for COPD meds?

Inhalation

What is the max dose of ipratropium?

12 puffs/day

How does levalbuterol different from albuterol?

More expensive

What are the ultra-laba?

Indacaterol, olodaterol, vilanterol

Which LABA has a greater effect?

Indacterol

What are long acting bronchodilators for?

patients high risk for exacerbations

What are LAMA examples?

Tiotropium
Aclidinium
Umeclindinium

What are ADRS of LAMA?

Tachycardia, blurred vision, narrow angle glaucoma, constipation, urinary retention, dry mouth

What is the difference between tiotropium and aclidinium?

Aclidinium: faster onset

What are the dosage forms of tiotropium?

DPI, SMI

What LAMAs are available only as DPIs?

Aclidium and umeclidinium

What are the LABA-LAMAs?

1. Umeclidium-vilanterol (DPI) 2. Umeclindinium-vilanterol-fluticasone (DPI) 3. Tiotropium-olodaterol (SMI)

What is a major concern of theophylline?

1. Closely monitored 2. Arrhythmias and seizures

What are the limits of CS?

Short term: acute exacerbations Long term: osteoporosis, atrophy, thinning of skin, cataract, adrenal suppression

When should you use CS?

Very sever COPD but increases risk for pneumonia

What are some ICS+bronchodilators?

Salmeterol + Fluticasone, Budesonide + Formoterol, Mometasone + Formoterol

What are PDEis?

Roflumilast

What are the ADRs of PDEis?

Weight loss, neuropsychitric

When would you use PDEis?

Severe COPD at risk for acute exacerbations

What are the CIs of PDEis?

CYP3A4 and 1A2 inducers

When should you consider antibiotics fo COPD?

1. Increased dyspnea 2. Increased sputum volume 3. Increased sputum purulence If patient has 2 or more