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copd Flashcards

1
Q

What is the duration of action for Salbutamol?

A

4 to 6 hours

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2
Q

What is the duration of action for Ipratropium Bromide?

A

6 to 8 hours

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3
Q

What class of medication is used for the treatment of Group A COPD? (mildest form of COPD)

A

Any bronchodilator

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4
Q

What class of medication is used for the treatment of Group B COPD?

A

LABA + LAMA

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5
Q

What class of medication is used for the treatment of Group E COPD?

A

LABA + LAMA
If eosinophils >300, LABA + LAMA + ICS

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6
Q

What differs a patient from Group A and Group B COPD?

A

Group A: CAT < 10, mMRC 0-1
Group B: CAT > 10, mMRC > 2

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7
Q

Name an example of LAMA?

A

Tiotropium Bromide

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8
Q

What class of bronchodilators does Ipratropium Bromide & Tiotropium Bromide belong to?

A

Muscarinic Receptor Antagonists

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9
Q

What is the duration of action for Tiotropium Bromide?

A

24 hours

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10
Q

What is the onset of action of Ipratropium and Tiotropium respectively?

A

Ipratropium: 5 to 30 mins
Tiotropium: 30 mins

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11
Q

Muscarinic receptor antagonists inhibits ___ receptor mediated bronchoconstrictions and reverses ____ mediated bronchospasm and mucus secretion.

A

Muscarinic receptor antagonists inhibits M3 receptor-mediated bronchoconstrictions and reverses vagal nerve mediated bronchospasm and mucus secretion.

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12
Q

What is the first line medication for COPD?

A

Muscarinic receptor antagonists (SAMA, LAMA)

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13
Q

What are the adverse effects of SAMA and LAMA?

A

Unpleasant taste
Dry mouth
Urinary retention

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14
Q

Name one LABA used for the treatment of COPD

A

Indacaterol
Duration of action: 24 hours

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15
Q

Can beta 2 agonist be used alone in COPD?

A

Yes

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16
Q

What is the second line medication for COPD GOLD Group A?

A

Beta 2 agonists

17
Q

In the treatment for Group A COPD, what is one common combination?

A

SAMA + SABA

18
Q

In the treatment for Group B and E COPD, what is one common combination?

A

Triple Inhaler:LAMA + LABA + Glucocorticoid

19
Q

What is used as an adjunct for more severe cases of COPD?

A

Theophylline

20
Q

Name an example of a phosphodiesterase-4 (PDE-4) Inhibitor

A

Roflumilast

via oral

21
Q

Inhibition of PDE-4 prevents breakdown of ____ resulting in ____ inflammatory cell activity, inhibition of ______ and _____ of smooth muscle.

A

Inhibition of PDE-4 prevents breakdown of cAMP resulting in reduced inflammatory cell activity, inhibition of fibrosis and relaxation of smooth muscle.

22
Q

What is Roflumilast indicated for?

A

Reduces episodes of exacerbation
Slows progress of fibrosis

23
Q

What are some adverse effect of Roflumilast?

A

Headache
Dizziness
Insomnia
Diarrhoea
Nausea
Decreased appetite
Weight loss

**caution in patients with hepatic impairment!

24
Q

Can a patient with liver disease be prescribed Roflumilast?

A

Yes but use with caution as Roflumilast relies on hepatic clearance

25
Q

Why is Azithromycin used in the treatment of COPD?

A

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

26
Q

What group of antibiotic does Azithromycin belong to?

27
Q

What are the adverse effects of Azithromycin?

A

Diarrhoea
Nausea and vomiting
Cardiac arrhythmia

28
Q

Azithromycin is contraindicated in patients with a history of _____ or _____

A

Cholestatic jaundice
Hepatic dysfunction

29
Q

List 2 antibiotics and their dosage which are given to patients prone to exacerbations

A

Azithromycin 250mg/day or 500mg three times per week for 1 year
Erythromycin 250mg two times a day for 1 year

30
Q

Name 1 antibiotic given to patients with chronic bronchitis and has frequent exacerbations

A

Pulse therapy with moxifloxacin (400mg/day) for 5 days every 8 weeks

31
Q

What are some vaccinations recommended for COPD patients?

A

Influenza
Covid
Pneumococcal
Tdap

32
Q

What smoking cessation options are there?

A

Nicotinic: Nicotine replacement
Varenicline
Antidepressants: Bupropion
Notrypttiline

33
Q

what are examples of mucolytics

cysteine derivatives
thiol derivatives

A

cysteine derivatives - acetylcysteine, carbocisteine

thiol derivatives - erdostein (effervescent tablets and oral granules)

34
Q

what is the MOA of mucolytics

A
  • free sulfhydryl group opens disulphide bonds in mucoproteins
  • lowers mucous viscosity
35
Q

what are the adverse effects of mucolytics

A
  • bronchospasm
  • anaphylactoid reactions - rash/HTN/dyspnoea/wheezing
  • GI disturbance
36
Q

what are the cautions of COPD

A

elderly or weakened patients with severe resp insufficiency
asthma patients

respi pharm (4 decks)

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