COPD Flashcards
What is the duration of action for Salbutamol?
4 to 6 hours
What is the duration of action for Ipratropium Bromide?
6 to 8 hours
What class of medication is used for the treatment of Group A COPD?
Any bronchodilator
What class of medication is used for the treatment of Group B COPD?
LABA + LAMA
What class of medication is used for the treatment of Group E COPD?
LABA + LAMA
If eosinophils >300, LABA + LAMA + ICS
What differs a patient from Group A and Group B COPD?
Group A: CAT < 10, mMRC 0-1
Group B: CAT > 10, mMRC > 2
Name an example of LAMA?
Tiotropium Bromide
What is the duration of action for Tiotropium Bromide?
24 hours
What is the onset of action of Ipratropium and Tiotropium respectively?
Ipratropium: 5 to 30 mins
Tiotropium: 30 mins
Muscarinic receptor antagonists inhibits ___ receptor mediated bronchoconstrictions and reverses ____ mediated bronchospasm and mucus secretion.
Muscarinic receptor antagonists inhibits M3 receptor-mediated bronchoconstrictions and reverses vagal nerve mediated bronchospasm and mucus secretion.
What is the first line medication for COPD?
Muscarinic receptor antagonists (SAMA, LAMA)
What are the adverse effects of SAMA and LAMA?
Unpleasant taste
Dry mouth
Urinary retention
Name one LABA used for the treatment of COPD
Indacaterol
Duration of action: 24 hours
Can beta 2 agonist be used alone in COPD?
Yes
What is the second line medication for COPD GOLD Group A?
Beta 2 agonists
In the treatment for Group A COPD, what is one common combination?
SAMA + SABA
In the treatment for Group B and E COPD, what is one common combination?
Triple Inhaler:LAMA + LABA + Glucocorticoid
What is used as an adjunct for more severe cases of COPD?
Theophylline
Name an example of a phosphodiesterase-4 (PDE-4) Inhibitor
Roflumilast
Inhibition of PDE-4 prevents breakdown of ____ resulting in ____ inflammatory cell activity, inhibition of ______ and _____ of smooth muscle.
Inhibition of PDE-4 prevents breakdown of cAMP resulting in reduced inflammatory cell activity, inhibition of fibrosis and relaxation of smooth muscle.
What is Roflumilast indicated for?
Reduces episodes of exacerbation
Slows progress of fibrosis
What are some adverse effect of Roflumilast?
Headache
Dizziness
Insomnia
Diarrhoea
Nausea
Decreased appetite
Weight loss
Can a patient with liver disease be prescribed Roflumilast?
Yes but use with caution as Roflumilast relies on hepatic clearance
Why is Azithromycin used in the treatment of COPD?
It works by preventing bacteria from growing by interfering with their protein synthesis
Azithromycin is also an antifibrotic and smooth muscle relaxant which reduces the risk of exacerbations or exacerbations due to bacterial infection
What group of antibiotic does Azithromycin belong to?
Macrolide
What are the adverse effects of Azithromycin?
Diarrhoea
Nausea and vomiting
Cardiac arrhythmia
Azithromycin is contraindicated in patients with a history of _____ or _____
Cholestatic jaundice
Hepatic dysfunction
List 2 antibiotics and their dosage which are given to patients prone to exacerbations
Azithromycin 250mg/day or 500mg three times per week for 1 year
Erythromycin 250mg two times a day for 1 year
Name 1 antibiotic given to patients with chronic bronchitis and has frequent exacerbations
Pulse therapy with moxifloxacin (400mg/day) for 5 days every 8 weeks
What are some vaccinations recommended for COPD patients?
Influenza CovidPneumococcalTdap
What smoking cessation options are there?
Nicotinic:Nicotine replacement Varenicline
Antidepressants:Bupropion Notrypttiline
