COPD Flashcards
What are the GOLD 1 FEV1% predicted classes?
Gold I FEV1%= >80% mild
Gold II FEV1%= 50-80%, moderate
Gold III FEV1%=30-50%, severe
Gold IV FEv1%= <30%, extremely severe
What are the steps in evaluating COPD patients?
Step 1 obtain spirometry FEV1/FVC= <70%, the use FEV1% categories to place patient in I,II,II, or IV
Step 2: assess airflow limitations, mMRC or CAT score
step 3: evaluate exacerbations, more than 1 hospital admission or more than 2=categories C or D
0-1 with no hospital admissions= categories A or B
What is the order of vaccine administration in patients >65 y/o?
vaccine naive >65y/o: give PVC 13, wait a year then given PPSV23
if patient got PPSV23 already give PCV13 a year later
What vaccine do you give if patient got PPSV23 before age 65.
wait and give PCV 13, wait another year, then give PCV13
Name 3 smoking cessation tx drugs(6)?
- Bupropion
- Nicotine gum
- Nicotine inhaler
- Nicotine spray
- nicotine patches
- Varenicline
What are of ADE Varenicline 2?
- nausea
- insomnia
What are ADE of nicotine patches 2?
- skin irritation
- insomnia
What is ADE nasal spray 1
-nasal irritation
What are ADE of Bupropion2?
- dry mouth
- insomnia
What are ADE of nicotine gum 2?
- indigestion/dyspepsia
- sore mouth
What are ADE of nicotine inhaler 1?
-sore throat and mouth
When should you use ICS for COPD?
- concomitant asthma with COPD
- blood eosinophils >300
- > 2 exacerbation per year
What are ADE of beta agonists?
- tachycardia
- tremors
Name 1 SAMA:
- ipratropium
- more prolonged effect than albuterol
What are ADE of anti muscarinic?
-dry mouth, metallic taste, cough
Name two LABA + LAMA medications
-Stiolto Respimat (tiotropium bromide and olodaterol Anoro Ellipta (umelclidinium bromide +vilanterol)
What do corticosteroids do?
- reduce capillary permeability to reduce mucous production
- inhibit prostaglandins synthesis
Name 1 drug for ICS+ LABA
-salmeterol and fluticasone
Name 1 drug for triple therapy LABA+LAMA+ICS
- Trelegy Ellipta
- dry powder delivery inhaler 1x/day
What is MOA of Roflumilast/Dalisrep?
- blocks PDE-4
- stops break down of cAMP= bronchodilation
What are the effects of Roflumilast /Dalisrep?
- prevent bronchial remodeling
- prevents mucociliary malfunction
When should you use Roflumilast?
- chronic bronchitis
- FEV1<40%
What are ADE of Roflumilast (5)?
- dizziness
- insomnia
- diarrhea
- weight loss
- back pain
What are contraindications for Roflumilast (2)?
- ciprofloxacin: increases serum concentration of Roflumilast
- liver disease
