COPD

Question 1

How would you start off treating COPD?

Answer 1

SABA or SAMA

Question 2

In step 2 of treating COPD, if FEV < 50% how would you treat it?

Answer 2

LABA/ICS or LAMA

Question 3

In step 2 of treating COPD, if FEV > 50% how would you treat it?

Answer 3

LABA or LAMA

Question 4

What is included in step 3 of treating COPD, if the first 2 steps are not effective?

Answer 4

• triple therapy
• LABA/ICS + LAMA
• if symptoms persist/unable to use inhaler - MR Theophylline

Question 5

How would you treat a chronic productive cough?

Answer 5

• With a mucolytic - carbocisteine (thins mucus)

Question 6

What should you be cautious with when using antimuscarinic bronchodilators?

Answer 6

• prostatic hyperplasia

- closed-angle glaucoma (with nebulised ipratropium)

Question 7

What are the side effects of antimuscarinic bronchodilators?

Answer 7

• Dry mouth

- Paradoxical bronchospasm ( unexpected constriction of smooth muscle walls of the bronchi)

Question 8

How would you treat ACUTE COPD exacerbations?

Answer 8

• Bronchodilator therapy (SAMA, SABA, Theophylline)
• via nebuliser with O2 OR IV aminophyline
• Oral prednisolone - 30mg OD for 7-14 days
• Antibiotics - for purulent sputum