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COPDFC Flashcards

1
Q

atrovent HFA & MOA

A

ipratropioum, shortt acting anticholinergic

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2
Q

ipratropium MOA

A

short acting anticholinergic

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3
Q

combivent, and MOA

A

ipratropium + albuterol, short acting anticholinergic , SABA

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4
Q

what is the MOA of anticholinergics for COPD?

A

block the action of acetylcholine at parasympathic sites in brochial smooth muscle leading to bronchodilation

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5
Q

spiriva & MOA

A

tiotropium, long acting anticholinergic

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6
Q

daliresp & MOA

A

roflumilast

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7
Q

symbicort & MOA

A

formoterol/budesonide, long acting Beta agonist, corticosteroid

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8
Q

advair discus & MOA

A

salmeterol / fluticasone, long acting Beta agonist, corticosteroid

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9
Q

LABA vs SABA effectiveness comparision

A

If used on regular basis, LABA are more effective and convenient than tx w/ SABA

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10
Q

SABA + anticholinergics effectiveness of combination. When to add an ICS?

A

Produce greater improvements in lung function than either drug given alone. Addition of an ICS to bronchodilators is appropriate for symptomatic COPD pts w/ more severe dz (stage 3-4). Avoid chronic tx w/ system corticosteroid due to unfavorable benefit-risk ratio in most pts.

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11
Q

COPD vaccinations each fall

A

influenza and pneumococcal (repeat if >65, and received vaccine more than 5 year ago)

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12
Q

Pts w/ severe hereditary alpha-1 antitrypsin deficiency, therapy?

A

May place on alpha-1 proteinase inhibitor (Prolastin, Aralast, or Zemaira) given as wkly IV infusion, many SE including anaphylaxis

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13
Q

Acute COPD exacerbation treatment

A

antibiotics, inhaled anticholinergic bronchodilator + oral steroid (taper steroid over 2 wks). Azithromycin 250 mg/d reduce risk of acute exacerbation b/c anti-inflammatory and immunomodulatory (may decrease hearing)

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14
Q

Anticholinergics MOA

A

blocks the action of acetylcholine and decrease cGMP at parasympathetic sites in bronchial smooth muscle causing bronchodilation.

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15
Q

Side effects of anticholinergics

A

SE: Dry mouth (more w/ tiotropium), URTI, pharyngeal irritation, bitter taste ,Caution: pts w/ myasthenia gravis, narrow angle glaucoma, BPH, bladder neck obstruction

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16
Q

Short Acting Anticholinergics, names and dosing

A

Ipratropium bromide (Atrovent HFA) 1-2 inhalations TID-QID (MDI), 0.5 mg TID-QID (NEB)

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17
Q

ipratropium + SABA, what is the SABA? What dosing?

A

+ albuterol (Combivent, Duoneb) 2 inhalations QID, 0.5 mg TID-QID (NEB), wait 2 min btw inhalations

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18
Q

if you are allergic to what should you not take combivent? What occurrence should lead pt to immediately dc combivent?

A

Combivent contain soy, caution pt w/ soy/peanut allergy or atropine. Can cause paradoxical bronchospasm (narrowing of airways, is life threatening), stop use and get emergency help.

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19
Q

Long Acting Anticholinergics, name and dosing? How to take? How often to clean device?

A

Tiotropium (Spiriva handihaler) 1 cap inhaled daily (requires 2 puffs), breathe in slowly and deeply, clean device 1x/month.

20
Q

LABA

A

Salmeterol, Formoterol, Arfomoterol, Indacaterol

21
Q

Side effects of long acting beta agonists

A

SE: tremor, shakiness, lightheadedness, cough, palpitations, hypokalemia, tachycardia, hyperglycemia

22
Q

If you add a ICS to LABA what are the risks/ benefits?

A

Combo w/ ICS increase pneumonia risk, however decrease exacerbations and improve lung function compare to individual components.

23
Q

advair diskus dose? Generic?

A

1 inhalation BID, salme/fluticasone

24
Q

SPIRIVA dose

A

1 cap daily (requires two puffs per cap)

25
Q

serevent diskus, generic and dosign

A

(Salmeterol) 1 inhalation BID

26
Q

symbicort generic , dosing?

A

formoterol/ budesonide, 2 inhalations BID

27
Q

foradil aerolizer, perforomist, GENERIC

A

formoterol

28
Q

arcapta and MOA, dosing

A

indacaterol, LABA, 74mg capsula USE WITH NEOHALER DAILY, do not swallow

29
Q

Brovana, generic, MOA, dosing

A

15 meg BID (NEB), arformoterol, LABA, it is the r isomer of formoterol

30
Q

MDI use

A

MDI: Shake well before use. Prime prior to first use (3-4 sprays into the air away from face) and again if inhaler has not been used for > 2 weeks.

31
Q

Roflumilast

A

Phosphodiesterase 4 inhibitor (Daliresp), increase cAMP levels, lead to reduced lung inflammation

32
Q

Roflumilast dosing

A

500 mcg PO daily

33
Q

Roflumilast side effects

A

SE: wt loss, decrease appetite, diarrhea, insomnia, depression, psychiatric events (suicidal)

34
Q

when taking combivent, how long do you wait between each dose of the two inhlations

A

about 2 minutes before taking the 1st puff

35
Q

why should pts close their eyes when taking atrovent or combivent?

A

it has an anticholinergic, so if it lands in their ey ie tcan cuse blurry vision, glaucoma, worsingn of eye conditions or eye pain

36
Q

counseling for how to use the spiriva handihaler

A

make sure you do not swallow the capsules, insert the capsule into the device, press the green piercing button once not more than once, breathe in slowly and deeply so that you can hear the capsule vibrate, hold breath as long as comofrotable, Repeat second puff, clean once a month

37
Q

copd causes

A

bronchitis and emphysema

38
Q

sxs of copd

A

chronic cough and sputum prudction, dyspnea

39
Q

emphysema

A

in the alveoli an inflammatory response due to noxious particles causes destruction of tissues of the lungs.

40
Q

risk factors

A

smoking, alpha 1 antitrypsin deficiency, dust chemical, pollustions

41
Q

bronchodilators how use

A

short acting rescue or scheduled.

42
Q

ipratropium bromide

A

atroven hfa- 1-2 puffs tid- qid

43
Q

albuterol + ipratropium

A

combivent 2 puff qid

44
Q

tiotropium

A

spiriva 1 capsule daily

45
Q

salmeterol flutciasone

A

advair- 1 puff bid.

46
Q

tudorza

A

long acting anticholinergic

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