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Z A Pharm III > COPD > Flashcards

COPD Flashcards

1
Q

COPD def

A

preventable and treatable
progressive persistent airflow limitation
chronic inflammatory response in airways
caused by noxious particles or gases

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2
Q

how many cig smokers get COPD

A

15-20%

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3
Q

Where does COPD rank for death

A

3rd

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4
Q

What are COPD risk factors

A

smoking
indoor air pollution
occupational dust and chemicals
outdoor air pollution

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5
Q

How COPD affects lungs

A 
mucus hypersecretion
ciliary dysfunction
airflow limitation
hyperinflation
gas exchange abnormalities
pulmonary hypertension
systemic effects
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6
Q

What are symptoms of COPD

A

dyspnea
chronic cough
chronic sputum production
exacerbations

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7
Q

What is required to diagnosis COPD

A

spirometry

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8
Q

What are the stages of COPD

A

GOLD 1 - Mild
GOLD 2 - Moderate
GOLD 3 - Severe
GOLD 4 - Very Severe

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9
Q

What are symptoms of GOLD 1 for COPD

A

FEV1 >= 80%

no chronic symptoms

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10
Q

What are symptoms of GOLD 2 for COPD

A

FEV1 between 50 and 80%

DOE

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11
Q

What are symptoms of GOLD 3 for COPD

A

FEV1 Between 30 and 50%

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12
Q

What are symptoms of GOLD 4 for COPD

A

FEV1 < 30%

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13
Q

What txt goals COPD

A 
smoke
reduce symptoms
improve exercise tolerance
minimize rate decline
maintain QOL
prevent exacerbations
limit complications
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14
Q

What are the COPD management pgm

A

assess and monitor disease
reduce risk factors
manage stable COPD
manage exacerbations

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15
Q

What are nonpharm COPD txts

A

smoking cessation
pulmonary rehab for GOLD 3 and 4 or B,C,D
O2
Surgery

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16
Q

What are pharm txts

A

Bronchodilators

corticosteroids

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17
Q

What are MOA anticholinergic bronchodilators

A

decrease cyclic GMP and cause bronchial smooth muscle relaxation

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18
Q

What are adverse effects anticho bronchodilators

A 
dry mouth
metallic taste
dry eyes
urinary retention
constipation
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19
Q

What are the anticho broncho meds

A

Ipratropium

Tiotropium

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20
Q

How use Ipratropium

A

short acting
2 puffs qid (12 in 24 hrs)
MDI or neb

21
Q

How use tiotropium

A

long acting

18 mcg inhaled via DPI qd

22
Q

What do cholinergic agents do

A

Salivation
Lacrimation
Urination
Defecation

23
Q

What are MOA B-2 agonists

A

stimulate B-2 receptors
increase CAMP
relax bronchial smooth muscle

24
Q

What are adverse effects B-2 agonists

A

tachycardia
tremor
hypokalemia

25
Q

What are the B-2 meds

A

Albuterol MDI

Salmeterol MDI

26
Q

How use albuterol MDI

A

Short acting

2 puffs q4-6 hr prn

27
Q

How use Salmeterol

A

long acting

1 inhalation q12h

28
Q

When use combo short acting bronchodilators

A

FEV1 < 60%
Combivent (ipratropium + albuterol)
2 puffs qid

29
Q

What is MOA methylxantine bronchodilator

A

block phosphodiesterase
Increase CAMP
relax bronchi and pulmonary blood vessel smooth muscle

30
Q

What are adverse effects of methylxantine bronchodilator

A 
drug interactions
restlessness
insomnia
GERD
palpitations
diuresis
NVD
headache
31
Q

What is a methylxantine bronchodilator med

A

Theophylline

32
Q

When should ICS be used

A

FEV1 < 60%

33
Q

What are adverse effects of ICS

A

pneumonia
candidiasis
hoarse voice

34
Q

What should a ICS be used with for COPD

A

LABA

35
Q

What is a ICS med

A

Fluticasone

88-440 mcg bid

36
Q

What is phosphodiesterase 4 inhibitor MOA

A

inhibit PDE4 involved with CAMP

37
Q

What are adverse effects with phosphodiesterase 4 inhibitor

A 
hepatic impairment
insomnia
weight loss
depression
suicide
D/N
38
Q

What is a phosphodiesterase 4 inhibitor med

A

Daliresp 500 mcg po qday

39
Q

What immunizations should COPD pts get

A

Influenza

Pneumococcal >65 age or FEV1 < 40%

40
Q

What are patient group A for COPD

A

GOLD 1 or GOLD 2

CAT < 10

41
Q

What are patient group B for COPD

A

GOLD 1 or GOLD 2

CAT >= 10

42
Q

What are patient group C for COPD

A

GOLD 3 or GOLD 4

CAT < 10

43
Q

What are patient group D for COPD

A

GOLD 3 or GOLD 4

CAT >= 10

44
Q

How treat Patient group A COPD

A

SAAC
or
SABA

45
Q

How treat patient group B COPD

A

LAAC
or
LABA

46
Q

How treat patient group C COPD

A

ICS + LABA
or
LAAC

47
Q

How treat patient group D COPD

A

ICS + LABA
and/or
LAAC

48
Q

What monitoring and follow-up is required for COPD

A 
spirometry >= every year
Questionaires 2-3 months
symptoms each visit
smoking each visit
meds and inhaler technique
exacerbation history
comorbidities
49
Q

How treat COPD exacerbations

A

SA bronchodilators
Oral corticosteroids (prednisone 40 mg po qd 5 days)
antibiotics ( sputum purulence and dyspnea/sputum volume)

Z A Pharm III (17 decks)

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