General info

Question 1

What is COPD?

Answer 1

Irreversible airway obstruction

Question 2

Managemnet - stable COPD

Answer 2

1. LABA or LAMA
2. LABA + LAMA
3. LABA + LAMA + ICS (3 month trial)

Question 3

LABA

Answer 3

Olodaterol (striverdi respimat)
Indaceterol (Onbrez Breezhaler)
Vilanterol with umeclinium (Anoro epilepta)

Question 4

LAMA

Answer 4

OD except Eklira (BD)
- Aclidinium (Eklira genuair)
- Glycopyronnium (Seebri Breezhaler)
- Umeclidinium (Incruse Elipta)
- Tiotropium (spriva handihaler)

Question 5

Spiriva respimat

Answer 5

Licensed as adjunct to LABA/ICS in asthma with 1 or more severe exacerbations in past year.

Question 6

SAMA

Answer 6

Ipatropium bromide (TDS)

Question 7

Cautions

Answer 7

Prostatic hyperplasia
Risk of angle-closure glaucoma
- Acute angle-closure glaucoma reported with nebulised ipratropium, esp when given with salbutamol.
- Protect eyes

Question 8

Side effects

Answer 8

Dry mouth (most common)
Paradoxical bronchospasm

Question 9

Management

Answer 9

Bronchodilator therapy
Corticosteroids
Antibiotics

Question 10

Bronchodilator therapy

Answer 10

Via nebuliser with oxygen if needed
e.g. SAMA, SABA, Theophylline
- Give IV aminiophylline if poor response to nebulised bronchodilator

Question 11

Corticosteroid

Answer 11

Short course of oral prednisolone
- 30 mg daily for 5 days

Question 12

Antibiotics

Answer 12

Amoxicillin 500 mg TDS for 5 days
Doxycycline - 200 mg on day 1, then 100 mg for 4 more days.
Clarithromycin 500 mg BD for 5 days.