Module 4 - COPD Exacerbation Treatment and NonPharm Interventions

Question 1

• Management of exercerbations

Answer 1

3 classes of medications most commonly used for COPD exacerbations

bronchodilators:
- initial treatment for exacerbation
- SABA with or without SAMA **

corticosteroids:
- improves FEV1 (short term) and improves oxygenation. risk of relapse
- no longer than 14 days (5-7 days)

antibiotics: 5-7 day duration

Question 2

• Summary of bronchodilators in COPD

__________ in COPD are central to symptom management and common given on a regular basis to prevent or reduce symptoms

Answer 2

inhaled bronchodilators in COPD are central to symptom management and common given on a regular basis to prevent or reduce symptoms

Question 3

• Summary of bronchodilators in COPD

regular and as needed use of ________ improves FEV1 and symptoms

Answer 3

regular and as needed use of SABA or SAMA improves FEV1 and symptoms

Question 4

• Summary of bronchodilators in COPD

combos of ________ are superior compared to either med alone in improving FEV1 symptoms

Answer 4

combos of SABA and SAMA are superior compared to either med alone in improving FEV1 symptoms

Question 5

• Summary of bronchodilators in COPD

________ significantly improve lung functions, dyspnea, health status and reduce exacerbation rates

Answer 5

LABAs and LAMAs significantly improve lung functions, dyspnea, health status and reduce exacerbation rates

Question 6

• Summary of bronchodilators in COPD

______ have a greater effect on exacerbation reduction compared with _______ and decrease hospitalizations

Answer 6

LAMAs have a greater effect on exacerbation reduction compared with LABAs and decrease hospitalizations

Question 7

• Summary of bronchodilators in COPD
  combo treatment with ______ reduces exacerbations AND increases FEV1 compared to monotherapy

Answer 7

combo treatment with LABA and LAMA reduces exacerbations AND increases FEV1 compared to monotherapy

Question 8

• Summary of bronchodilators in COPD

_________ improves the effectiveness of pulmonary rehabilitation in creasing exercise performance

Answer 8

tiotropium (which is a LAMA) improves the effectiveness of pulmonary rehabilitation in creasing exercise performance

Question 9

• Summary of bronchodilators in COPD

_________ exerts a small bronchodilator affect in stable COPD and that is associated with modest symptomatic benefits

Answer 9

theophylline exerts a small bronchodilator affect in stable COPD and that is associated with modest symptomatic benefits

Question 10

• Pulmonary rehab and self management (5pts)

Answer 10

1. pulm rehab improves dyspnea, health status and exercise tolerance in stable pts
2. pulm rehab reduces hospitalizations among patients who have had a recent exacerbation (< weeks from prior hospitalization)
3. pulm rehab leads to a reduction in sx of anxiety and depression
4. education alone has not been shown to be effective
5. self mgmt intervention with communication with HCP improves health status, decreases hospitalizations, and ER visits

Question 11

• Oxygen Treatment

Answer 11

indicated for severe resting hypoxemia (<88%) should all receive supplemental continuous O2

• all pts receiving O2 (>15 hours a day) with chronic respiratory failure as been shown to increase survival rate (only with severe resting hypoxemia pts)