COPD Case

Question 1

airflow obstruction is defined as FEV1 < __ predicted
and FEV1/FVC ratio < __ predicted

Answer 1

80%
70%

Question 2

GOLD criteria is based on

Answer 2

FEV1/FVC < 70%

Question 3

COPD treatment

Answer 3

Question 4

4 steps in COPD classification/staging

Answer 4

1. assess symptom severity (CAT/mMRC)
2. assess future exacerbation risk (GOLD)
3. risk stratify (ABCD)
4. initiate tx (ABCD)

Question 5

COPD med given to all

Answer 5

Combivent (SABA+SAMA)

Question 6

what combo has been more effective than monotherapy for COPD and is available in a single inhaler

Answer 6

combivent -> ipratropium/albuterol (SAMA/SABA)

Question 7

best choice med for COPD w. significant airflow obstruction and chronic sx

Answer 7

LAMA - Spiriva

Question 8

when should ICS be used for COPD

Answer 8

when LABA or LAMA have been maxed out
FEV < 50%
not first line tx

Question 9

4 LABA/ICS combos

Answer 9

symbicort
advair
breo ellipta
dulera

Question 10

2 LAMA/ICS combos

Answer 10

anoro ellipta
stiolto respimat

Question 11

tx not recommended in COPD

Answer 11

long term systemic steroids

Question 12

2 non pharm options for COPD

Answer 12

O2
pulmonary rehab

Question 13

4 indications for O2 in COPD patients

Answer 13

resting SpO2 < 88% RA
e.o:
pulm HTN
CHF
polycythemia

Question 14

MOA for SABA/LABA

Answer 14

bronchiole vasodilation

Question 15

MOA for SAMA/LAMA

Answer 15

bronchiole vasodilation
decrease mucous production

Question 16

MOA for ICS

Answer 16

decrease inflammation/wall edema

Question 17

MOA for theophylline

Answer 17

bronchiole vasodilation

Question 18

2 tools to monitor pharmacotherapy effectiveness for COPD

Answer 18

CAT/mMRC
FEV 1