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Pharmacology > COPD > Flashcards

COPD Flashcards

1
Q

What are the GOLD 1 FEV1% predicted classes?

A

Gold I FEV1%= >80% mild
Gold II FEV1%= 50-80%, moderate
Gold III FEV1%=30-50%, severe
Gold IV FEv1%= <30%, extremely severe

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2
Q

What are the steps in evaluating COPD patients?

A

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

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3
Q

What is the order of vaccine administration in patients >65 y/o?

A

vaccine naive >65y/o: give PVC 13, wait a year then given PPSV23
if patient got PPSV23 already give PCV13 a year later

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4
Q

What vaccine do you give if patient got PPSV23 before age 65.

A

wait and give PCV 13, wait another year, then give PCV13

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5
Q

Name 3 smoking cessation tx drugs(6)?

A
  1. Bupropion
  2. Nicotine gum
  3. Nicotine inhaler
  4. Nicotine spray
  5. nicotine patches
  6. Varenicline
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6
Q

What are of ADE Varenicline 2?

A
  • nausea

- insomnia

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7
Q

What are ADE of nicotine patches 2?

A
  • skin irritation

- insomnia

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8
Q

What is ADE nasal spray 1

A

-nasal irritation

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9
Q

What are ADE of Bupropion2?

A
  • dry mouth

- insomnia

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10
Q

What are ADE of nicotine gum 2?

A
  • indigestion/dyspepsia

- sore mouth

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11
Q

What are ADE of nicotine inhaler 1?

A

-sore throat and mouth

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12
Q

When should you use ICS for COPD?

A
  • concomitant asthma with COPD
  • blood eosinophils >300
  • > 2 exacerbation per year
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13
Q

What are ADE of beta agonists?

A
  • tachycardia

- tremors

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14
Q

Name 1 SAMA:

A
  • ipratropium

- more prolonged effect than albuterol

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15
Q

What are ADE of anti muscarinic?

A

-dry mouth, metallic taste, cough

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16
Q

Name two LABA + LAMA medications

A 
-Stiolto Respimat (tiotropium bromide and olodaterol
Anoro Ellipta (umelclidinium bromide +vilanterol)
17
Q

What do corticosteroids do?

A
  • reduce capillary permeability to reduce mucous production

- inhibit prostaglandins synthesis

18
Q

Name 1 drug for ICS+ LABA

A

-salmeterol and fluticasone

19
Q

Name 1 drug for triple therapy LABA+LAMA+ICS

A
  • Trelegy Ellipta

- dry powder delivery inhaler 1x/day

20
Q

What is MOA of Roflumilast/Dalisrep?

A
  • blocks PDE-4

- stops break down of cAMP= bronchodilation

21
Q

What are the effects of Roflumilast /Dalisrep?

A
  • prevent bronchial remodeling

- prevents mucociliary malfunction

22
Q

When should you use Roflumilast?

A
  • chronic bronchitis

- FEV1<40%

23
Q

What are ADE of Roflumilast (5)?

A
  • dizziness
  • insomnia
  • diarrhea
  • weight loss
  • back pain
24
Q

What are contraindications for Roflumilast (2)?

A
  • ciprofloxacin: increases serum concentration of Roflumilast
  • liver disease
25
Q

How do you treat emphysema?

A

-AAT (alpha anti-trypsin infusion therapy)

26
Q

What risk is placed on patient taking AAT?

A

mad cow disease

27
Q

Common bacterial causes of uncomplicated exacerbations

FEV1>50%

A
  • S. pneumonia
  • M. cattarhalis
  • H. flu
  • H. paraflu
28
Q

What is the tx for uncomplicated bacterial exacerbations

A
  • macrolide
  • doxycycline
  • 2nd gen cephalosporin
29
Q

Common causes of bacterial complicated exacerbations, FEV1 <50% byt greater than 30%?

A
  • Bacterial resistance
  • S. pneumonia
  • M. cattarhalis
  • H. flu
  • H. paraflu
30
Q

What is tx for bacterial complicated exacerbations?

A

augmentin
-fluoroquinolones levofloxacin, moxifloxacin
NOT CIPROFLOXACIN

31
Q

What is common cause of COPD exacerbations in nursing homes patients?

A

P. areuginosa

32
Q

How do you treat P. aeruginosa?

A
  • levofloxacin

- 3 or 4th gen cephalosporin

33
Q

When do you need to prescribe oxygen to COPD patient?

A
  1. when SaO2% <88%, PaO2 <55mmg

2. re assess in 60-90 days, keep SaO2 above or equal to 90%

34
Q

T/F You don’t a prescription for O2

A

False, you do need prescription to give O2

Pharmacology (47 decks)

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