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NAPLEX Review > COPD > Flashcards

COPD Flashcards

1
Q

Sx of COPD

A

dyspnea, chronic cough, sputum production and wheezing

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2
Q

Most common cause of COPD

A

smoking

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3
Q

Emphysema definition

A

destruction of alveoli

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4
Q

Bronchitis definition

A

inflammation and narrowing of the bronchial tubes

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5
Q

What deficiency makes someone at a higher risk of developing COPD

A

alpha-1 antitrypsin (AAT) deficiency

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6
Q

Limitation of airflow is reversible in someone with COPD or asthma?

A

Asthma - NOT COPD

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7
Q

What is required to diagnose COPD

A

spirometry

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8
Q

What post-bronchodilator FEV1/FVC confirms diagnosis of COPD?

A

<0.70

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9
Q

COPD vs asthma

age of onset

A

COPD: >40
Asthma: <40

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10
Q

COPD vs asthma

Smoking hx

A

COPD: usually >10 years
Asthma: uncommon

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11
Q

COPD vs asthma

Sputum production

A

COPD: common
Asthma: infrequent

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12
Q

COPD vs asthma

Allergies

A

COPD: Uncommon
Asthma: Common

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13
Q

COPD vs asthma

Symptoms

A

COPD: Persistent
Asthma: Intermittent and variable

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14
Q

COPD vs asthma

Disease process

A

COPD: Progressive, worsens over time
Asthma: Stable, does not worsen over time

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15
Q

COPD vs asthma

Exacerbations

A

COPD: Common
Asthma: Common

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16
Q

COPD vs asthma

First-line treatment

A

COPD: Bronchodilators
Asthma: Inhaled corticosteroid

17
Q

What are the four aspects of COPD assessment

A

Degree of airflow limitation
Symptoms
Risk of exacerbations
Presence of comorbidities

18
Q

What are the FEV1 measurements in each GOLD category?

A

Gold 1 - mild - FEV1 >80%
Gold 2 - moderate - FEV1 50-80%
Gold 3 - severe - FEV1 30-50%
Gold 4 - very severe - FEV1 <30%

19
Q

What is the mMRC and what does it test?

A

Dyspnea scale that assesses breathlessness

Higher score = worse

20
Q

What exacerbation history, CAT score, and mmRC score puts patients in COPD groups A, B, C, and D

A

D: 2 exacerbations or 1 hospitalization, CAT 10 or more, mMRC 2 or more
C: 2 exacerbations or 1 hospitalization, CAT < 10, mMRC 0-1
B: 0-1 exacerbations, CAT 10 or more, mMRC 2 or more
A: 0-1 exacerbations, CAT < 10, mMRC 0-1

21
Q

Non-pharm COPD therapy

A

Smoking cessation - only one to slow progression

Vaccines reduce hospitalizations (flu and pneumonia vaccine)

22
Q

Do COPD medications modify long-term decline in lung function, reduce mortality, decrease sx, or prevent complications?

A

only decrease sx and prevent complications (exacerbations and hospitalizations)

23
Q

Initial pharmacologic therapy for each COPD group A, B, C, and D

A

A: SABA or SAMA PRN, LABA or LAMA
B: LAMA or LABA
C: LAMA
D: LAMA or LAMA + LABA or LABA + ICS if eosinophils >300

24
Q

When should you initiate antibiotics in someone with a COPD exacerbation?

A

Increased sputum purulence, sputum volume, dyspnea or if mechnaical ventilation is required
Utilize for 5-10 days

25
Q

What ICS products are FDA approved for COPD?

A

None

26
Q

What LABA products are used in COPD?

A 
Salmeterol (Serevent)
Formoterol neb
Indacaterol
Arformoterol
Olodaterol
27
Q

What LAMA products are used in COPD?

A 
Tiotropium (spiriva)
Aclindinum
Glycopyrrolate
Revefenacin (Yupelri)
Umeclidinium (Incruse)
28
Q

What ICS/LABA products are used in COPD?

A

Budesonide/formoterol (Symbicort)
Fluticasone/salmeterol (Advair)
Fluticasone/vilanterol (Breo)

29
Q

What LAMA/LABA products are used in COPD?

A 
Aclidinium/formoterol (Duaklir)
Glycopyrrolate/formoterol (Bevespi)
Glycopyrrolate/indacaterol (Utibron)
Tiotropium/olodaterol (Stiolto)
Umeclidinium/vilanterol (Anoro)
30
Q

What LAMA/LABA/ICS products are used in COPD?

A

Umeclidinium/vilanterol/fluticasoen (Trelegy)

31
Q

What muscarinic antagonists/anticholinergics are used for COPD?

A

SAMA: Ipratropium (Atrovent) + albuterol (combivent)
LAMA: Tiotropium (Spiriva)

32
Q

Muscarinic antagonist SE, monitoring

A

SE: dry mouth
Monitoring: smoking status, COPD questionnaires, annual spirometry

33
Q

What beta-2 agonists are used in COPD?

A

Salmeterol + fluticasone (Advair)

Formoterol + budesonide (Symbicort)

34
Q

Beta-2 agonist SE

A

nervousness, tremor, tachycardia, palpitations, hyperglycemia, decreased K

35
Q

What phosphodiesterase-4 inhibitor is used in COPD? How does it work?

A

Roflumilast (Daliresp)

Decreases lung inflammation

36
Q

Roflumilast CI and SE

A

CI: Moderate to severe liver impairment
SE: Diarrhea, weight loss

NAPLEX Review (79 decks)

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