COPD 2: Treatment Flashcards

1
Q

When following up on a patient’s COPD what are the two catgegories that must be assessed

A

Dyspnea and exacerbations

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2
Q

What is the regimen change if a patient has a follow up for COPD and the dyspnea has gotten worse

A

Start using a LABA and LAMA

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3
Q

What is the two regimen change options if a patient has a follow up for COPD and the exacerbations are worse

A

Start using a LABA and LAMA or start using a LABA and ICS

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4
Q

When would a patient use a LABA and ICS regimen change option

A

If their eosinophils are greater than 300 or their eosionophils are greater than 100 AND 2 or more moderate exacerbation or 1 hospitalization

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5
Q

What cell line usually causes the inflammation in COPD

A

Neutrophils

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6
Q

What is the cell line that can cause inflammation in COPD but usually does not unless under certain circumstances, what are those circumstances

A

Eosinophils, exacerbatons and the patient has both ashtma and COPD

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7
Q

Increased eosinophils are associated with what in COPD

A

increased risk of COPD exacerbations, reduced lung function

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8
Q

T/F: Inhaled corticoidsteriods are more likely to cause pneumonia if used alone in COPD patients

A

True

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9
Q

What are the combination ICS and LABA medications that are apporved for COPD

A

Symbicort (budenoside/Formoterol), Advair Diskus and Adbair HFA (fluticasone propionate/salmeterol), Breo Ellipta (fluticasone furoate/vilanterol)

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10
Q

What are side effects of inhaled corticosteroids

A

thrush, osteoporosis, cataracts, pneumonia

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11
Q

What are risk factors for a patient to get pneumonia from their ICS

A

prior pneumonia, current smoker, greater than 55 years old, overweight, FEV1 is between 30% and 50%, blood eosinophil is less than 2%

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12
Q

What is the triple therapy that is approved for COPD

A

Fluticasone furoate and umeclidinium and Vilanterol

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13
Q

What is the result of using phosphodiesterase 4

A

supression of action in neutrophils, macrophages, and CD8 T cells

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14
Q

What is drug is a PDE4 inhibitor

A

roflumilast (Daliresp)

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15
Q

When would PDE4 inhibitors be used in a patient

A

chronic cough and/or sputum production, 1 hospitalization in the past year, add-on therapy for FEV1 less than 50% predicted

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16
Q

What are the side effects of PDE4 inhibitors

A

diarrhea, weight decrease, nausea

17
Q

T/F: CYP34A enzymes metabolize PDE4 inhibitors

A

True

18
Q

What macrolide would be added to a patient’s regimen for COPD, when

A

azithromycin, severe COPD with multiple exacerbations, adherent to bronchodilator and anti-inflammatory medication, not smoking tobacco