COPD 2: Treatment Flashcards
When following up on a patient’s COPD what are the two catgegories that must be assessed
Dyspnea and exacerbations
What is the regimen change if a patient has a follow up for COPD and the dyspnea has gotten worse
Start using a LABA and LAMA
What is the two regimen change options if a patient has a follow up for COPD and the exacerbations are worse
Start using a LABA and LAMA or start using a LABA and ICS
When would a patient use a LABA and ICS regimen change option
If their eosinophils are greater than 300 or their eosionophils are greater than 100 AND 2 or more moderate exacerbation or 1 hospitalization
What cell line usually causes the inflammation in COPD
Neutrophils
What is the cell line that can cause inflammation in COPD but usually does not unless under certain circumstances, what are those circumstances
Eosinophils, exacerbatons and the patient has both ashtma and COPD
Increased eosinophils are associated with what in COPD
increased risk of COPD exacerbations, reduced lung function
T/F: Inhaled corticoidsteriods are more likely to cause pneumonia if used alone in COPD patients
True
What are the combination ICS and LABA medications that are apporved for COPD
Symbicort (budenoside/Formoterol), Advair Diskus and Adbair HFA (fluticasone propionate/salmeterol), Breo Ellipta (fluticasone furoate/vilanterol)
What are side effects of inhaled corticosteroids
thrush, osteoporosis, cataracts, pneumonia
What are risk factors for a patient to get pneumonia from their ICS
prior pneumonia, current smoker, greater than 55 years old, overweight, FEV1 is between 30% and 50%, blood eosinophil is less than 2%
What is the triple therapy that is approved for COPD
Fluticasone furoate and umeclidinium and Vilanterol
What is the result of using phosphodiesterase 4
supression of action in neutrophils, macrophages, and CD8 T cells
What is drug is a PDE4 inhibitor
roflumilast (Daliresp)
When would PDE4 inhibitors be used in a patient
chronic cough and/or sputum production, 1 hospitalization in the past year, add-on therapy for FEV1 less than 50% predicted