COPD Drugs Lecture PDF

Question 1

Most common sources of acute exacerbation of COPD (4)

Single most important etiologic agent in development of COPD

Answer 1

• strep pneumoniae
• haemophilus influenzae
• mycoplasma pneumonaie
• influenza and adenovirus

-Chronic inhalation of tobacco smoke

Question 2

2 effective drug classes for treatment of COPD

Answer 2

• inhaled B2 adrenergic agonists (short term or long acting)

- short acting antimuscarinic anticholinergic agents

Question 3

Advantages of combo therapy of anticholinergics and B2 agonists in treatment of COPD (2)

Answer 3

• rapid onset of action and longer duration

- fewer side effects

Question 4

What type of glucocorticoid has been seen to improve and reduce severity of COPD exacerbation?

Answer 4

Systemic - prednisone for example

Question 5

Antibiotic treatment for COPD exacerbation

Answer 5

Based on local resistance patterns and initiated in patients whose sputum characteristics have changed, shown to be effective in decreasing short term mortality

Question 6

Examples of antibiotic treatment in COPD (4)

Answer 6

• amoxicillin
• amoxicillin/clauvonic acid (augmentin)
• doxycycline (tetracycline)
• clarithromycin (macrolide)

Question 7

Varenicline (Chantix) drug class and function

Answer 7

• Centrally acting nicotine receptor antagonist
• appears most effective agent for smoking cessation in long term treatment of COPD, exacerbations of mental illness with use have been reported

Question 8

• Inhaled short acting bronchodilators in COPD patients treatment
• Inhaled long acting bronchodilators in COPD patients treatment

Answer 8

• Short acting use on regular basis not recommended, used for acute relief
• Regular lone treatment recommended for patients with moderate to severe dyspnea or increased risk of exacerbations

Question 9

Inhaled corticosteroids and progression of COPD

Answer 9

They do NOT slow progression or reduce mortality of COPD, but improve symptoms less dramatically than in asthmatic patients, not recommended for use alone

Question 10

Theophylline function in COPD

Answer 10

Not first line but can be tried in patients with persistent symptoms despite treatment with inhaled triple therapy

Question 11

Triple therapy

Answer 11

LABA, LAMA, and an inhaled corticosteroid regimen for treatment of COPD

Question 12

Rofluminast (Daliresp) durg class and function

Answer 12

• PO phosphodiesterase 4 inhibitor
• approved to reduce risk of exacerbations in adult patients with severe COPD associated with chronic bronchitis and history of exacerbations, not a bronchodilator

Question 13

Rolfumilast (daliresp) ADR’s (2)

Answer 13

• N/V/D

- psychiatric effects

Question 14

Azithromycin drug class and function in COPD

Answer 14

• macrolide antibiotic
• use once daily can reduce risk of exacerbation over one year and improve quality of life in patients with COPD at increased risk of exacerbation

Question 15

Antianxiety and antidepressants in COPD treatment DOC and why? What should be avoided?

Answer 15

• Buspirone (Buspar) 5-10mg PO as it does not suppress ventilatory drive, does take SEVERAL weeks to become effective
• Benzodiazepines should be avoided

Question 16

Oxygen therapy for COPD

Answer 16

Shown to improve survival and quality of life in patients with COPD and chronic hypoxemia, results best with continuous administration preventing cor pulmonale

Question 17

Treatment guidelines of COPD (GOLD Guidelines)

Answer 17

Framework for management based on assessment of symptoms and risk for exacerbation in addition to COPD severity, classified into 1 of 4 additional categories for management from group A (few symptoms, low risk), B (increased symptoms, low risk) C (few symptoms, high risk) and D (increased symptoms, high risk

Question 18

Combivent Respimat

Answer 18

A single inhaler combo of SABA with ipratropium that is more effective than either drug alone

Question 19

2 primary goals of COPD management

Answer 19

• reduce symptoms and improve patients health status

- reduce risks and mortality by managing exacerbations