Lecture 10 - pharmaceutical care of COPD

Question 1

What is considered in the patent history when diagnosing COPD?

Answer 1

past and present occupation, smoking history, other medical conditions, frequent of exacerbations, exercise limitation, weight loss, social and family support

Question 2

what is FEV1

Answer 2

indicates the amount of air exhaled with maximum effort in the first second. in pre and post bronchodilator determines the effects of bronchodilators on the airways.

Question 3

what is the FVC?

Answer 3

the FVC is the Toal volume of air exhaled with maximal effort

Question 4

what is FEV1/FVC?

Answer 4

less than 0.7 - a diagnosis of accord can be made

used as a marker for progression of COPD

Question 5

what is FEV1/FVC?

Answer 5

less than 0.7 - a diagnosis of accord can be made

used as a marker for progression of COPD

Question 6

what are the aims of management of stable COPD?

Answer 6

reduce symptoms, improve exercise tolerance, improve health related quality of life, prevent exacerbations, provide a package of care that meets the patients needs, provide treatment that minimises the risk of adverse effects, reduce mortality, prevent disease progression

Question 7

what are non-pharmacological managements?

Answer 7

smoking cessation

pulmonary rehabilitation,

vaccination

physiotherapy

nutrition

treatment of anxiety and depression

Question 8

descried the medications sued for different phases of copd management

Answer 8

breathlessness and or exercise limitation: Saba or same

exacerbations or persistent breathlessness: FEV1> 50% use LABA or LAMA

FEV1< 50% : use LABA and ICS or LAMA

persisting exacerbations or breathlessness: LAMA + LABA + ICS

Question 9

what are corticosteroids used in combination with?

Answer 9

LABA

Question 10

what are corticosteroids adverse effects?

Answer 10

neurophysiological, mucoskeletal, endocrine or metabolic, skin, gastrointestinal, ophthalmic, immunosuppression

Question 11

what are corticosteroids adverse effects?

Answer 11

neurophysiological, mucoskeletal, endocrine or metabolic, skin, gastrointestinal, ophthalmic, immunosuppression

Question 12

when is Saba used ?

Answer 12

Used only in mild COPD but all patients will normally have a SABA inhaler

Question 13

when is laba used

Answer 13

Only used in combination with ICS or LAMA
Used twice a day
Different chemistry
Formoterol – rapid onset: long acting
Salmeterol – slow onset: long acting

Question 14

when is lama used?

Answer 14

LAMA – SMC approved for patients with FEV1 less than 50%
Little effect on lung function but large effect on quality of life