COPD

Question 1

COPD

def, cause, presentation

Answer 1

not fully reversible airway obstruction

cause: tobacco smoke

DX: progressive SOB, chronic cough or sputum production, hx of risk factors.

Question 2

DX COPD

Answer 2

Spirometry to assess lung function (FEV1/FVC less than 70)

Question 3

GOLD Classification

Answer 3

Gold 1 (FEV greater than 80%)
Gold 2 (FEV 50 -79)
Gold 3 (FEV 30 - 49)
Gold 4 (FEV less than 30)

Question 4

Selection of TXT

Answer 4

by risk of exacerbations (less than 1 or more than 2)
and
assessment of symptoms (CAT less than 10 or over or = to 10; mMRC 0-1 or more than 2)

Question 5

Non-pharm?

Answer 5

Smoking cessation (slow progression), Vaccinations (flu + pneumonia), assess inhaler techniques and adherence

Question 6

Pharm?

facts

Answer 6

Do not slow the progression( does not decrease mortality). They only prevent complications such as exacerbations and hospitalizations (morbidity)

Question 7

Ipratropium

Brand, SE, Avoid

Answer 7

Atrovent HFA, Combivent(+albuterol)
SE: Dry mouth, URI.
Avoid: MG, BPH, narrow-angle glaucoma, urinary retention

Question 8

Tiotropium

Answer 8

Brand: Spiriva Handihaler, Respimat
SE: Dry mouth, URI
Avoid: MG, BPH, urinary retention, Narrow-angle glaucoma

Question 9

Glycopyrrolate

Answer 9

Seebri Neohaler (Cuvposa liquid formulation)
SE: Dry mouth, URI
Avoid: MG, BPH, urinary retention, Narrow-angle glaucoma

Question 10

Umeclidinium

Answer 10

Incruse Ellipta

Question 11

Salmeterol

Answer 11

Servent Diskus

SE: Nervousness, tremor, tachy, cough, hyperglycemia (B2 agonist in islet cells), decrease K

Question 12

Formoterol

Answer 12

Perforomist
LABA
SE: SE: Nervousness, tremor, tachy, cough, hyperglycemia (B2 agonist in islet cells), decrease K

Question 13

Indacaterol

Answer 13

Arcapta Neohaler
LABA
SE: SE: Nervousness, tremor, tachy, cough, hyperglycemia (B2 agonist in islet cells), decrease K

Question 14

Arformoterol

Answer 14

Brovana
LABA
SE: SE: Nervousness, tremor, tachy, cough, hyperglycemia (B2 agonist in islet cells), decrease K

Question 15

Roflumilast

Answer 15

Daliresp
PDE-4 inhibitor
SE: Diarrheam weight loss
avoid in liver impairment, Nitro- products, 3A4 enzyme induc/inhib