Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > COPD meds > Flashcards

COPD meds Flashcards

1
Q

COPD is characterized by airflow obstruction due to:

A

Chronic bronchitis

Ephysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is chronic bronchitis?

A

Chronic or recurrent excess mucus secretion into the bronchial tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Characterize the chronic bronchitis cough

A

Most days >3 months/year for at least 2 consecutive years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is emphysema defined?

A

Defined by anatomic pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is emphysema characterized by?

A

Permanent enlarged air spaces and destruction of alveolar walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the key component of the chronic bronchitis hx?

A

Impressive hx of productive cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How are chronic bronchitis pts described?

A

Blue bloaters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why are chronic bronchitis pts described as blue bloaters?

A

CO2 retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Two main PE findings in chronic bronchitis:

A

Percussion is resonant

Breath sounds are distant to auscultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the key hx of emphysema

A

Minimal cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you describe pts with emphysema and why?

A

Pink puffers

Tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does pursed lip breathing compensate for in emphysema pts?

A

Compensate for loss of elastic recoil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why do emphysema pts sit forward with hands on knees?

A

Minimizes energy of breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are two key PE findings in pts w/ emphysema?

A

Accessory muscle use

Hyperresonant percussion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a major RF for chronic bronchitis and emphysema?

A

Cigarette smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Is inflammation in COPD the same or different than inflammation of asthma?

A

Different

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is COPD characterized?

A

By exacerbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the definition of exacerbation of COPD?

A

Worsening of pts sx that is beyond normal day-to-day variations
Leads to change in medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How many exacerbations do pts have yearly?

A

1-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What % of exacerbations can be handled out patient?

A

80%

21
Q

What are sx of severe exacerbations? Where should they be managed?

A

Accessory muscle use
Cyanosis
Peripheral edema
Hospital

22
Q

What are sx of life-threatening exacerbations? Where should they be managed?

A

Mental status changes
Worsening respiratory status
Hemodynamic instability
ICU

23
Q

What are the COPD medication classes?

A 
Cholinergic antagonists
Sympathomimetics
Combination anticholinergics/b2 agonists
Inhaled corticosteroids
Long-term oxygen
Antibiotics
24
Q

What are cholinergic antagonists also known as?

A

Anti-muscarinic agents

Anticholinergics

25
Q

What are sympathomimetrics also known as?

A

Beta 2 agonists

26
Q

Is the long term O2 high or low dose?

A

Low dose

27
Q

When do you use abx for COPD?

A

Exacerbations, not as prophylaxis

28
Q

What line of therapy are inhaled cholinergic antagonists (ICA) and for what severity of COPD?

A

1st line in stable COPD

29
Q

What are the available ICA agents?

A

Ipratropium
Tiotropium
Atropine

30
Q

Do ICAs have more or less side effects that sympathomimetics?

A

Less

31
Q

What line of tx are sympathomimetics?

A

2nd line

32
Q

When are sympathomimetics the drug of choice?

A

Acute exacerbations

33
Q

What do you do if response to ipratropium is unsatisfactory?

A

Begin trial of sympathomimetics

34
Q

Do inhaled corticosteroids (ICS) modify lung function decline or improve mortality?

A

No

35
Q

When are ICS recommended?

A

Pts w/ severe or very severe COPD w/ frequent exacerbations

36
Q

What are some AEs of ICS?

A

Oropharyngeal candidiasis

Hoarse voice

37
Q

Should you use ICS long term?

A

No, due to AEs

38
Q

What has continuous O2 therapy been shown to do?

A

Decrease mortality
Improve quality of life
Reduce times in hospital

39
Q

How do you administer O2?

A

Via nasal canula @ 2-3 L/min

40
Q

What is the goal of long term O2?

A

Raise PaO2 to > 60 mm Hg

41
Q

Why do you not raise PaO2 too high?

A

Don’t want to depress respiratory drive

42
Q

What is a risk of inhibiting respiratory drive?

A

Death

43
Q

What do you have to avoid on long term O2?

A

Flames (smoking)

44
Q

When are abx only effective for COPD?

A

Infection

45
Q

How long do you use the abx for COPD infections?

A

7-10 days

46
Q

What is the MC abx used w/ COPD infection?

A

Azithromycin
3rd generation macrolide
for 3-5 days

47
Q

Summary of COPD pharmacotherapy

A

See slide 61

48
Q

Stepwise COPD drug therapy

A

1) Short acting bronchodilator for acute sx relief
2) Long acting bronchodilator
3) Combination anticholinergic + beta agonist bronchodilator
4) consider theophylline
5) Combination inhaled corticosterouds + LABA

49
Q

What is the difference between inflammatory cell infiltration w/ asthma and inflammation w/ COPD?

A

Asthma = eosinophils and mast cells

COPD: caused by neutrophils, macrophages, T lymphocytes

Pharm (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions