MW L5 COPD treatment Flashcards
Most effective treatment for COPD?
Stop smoking :|
Do we use bronchodilators in COPD?
Yes, but limited effect as bronchoconstriction is not a major cause of airway obstruction
Do we use muscarinic atnagonists for COPD?
Yes
Ipratropium bromide & Tiotropium
What is new licensed in 2013 and not in the notes?
Aclidinium (fast M2 off time)
What M do we ideally want to block?
M3 (M2 block would antagonise its effects as M2 is negative feedback on ACh release)
What can we used for excessive mucus secretion?
Muscarinic antagonists
What is shown to be good for mucus secretion in trials? (2)
Neurokinin antagonists
Agents inhibiting sensory fiber activation
EGF stands for
Epidermal growth factor
EGF receptor is in pathway to ….
mucus production
What form is active EGF receptor
Phosphorylated (EGFR kinase inhibitors are used in cancer, being trialed for COPD)
Do we use corticosteroids in COPD?
Some benefit in reducing hospitalisation… not much
What does PDE III do?
What does PDE IV do?
III - broncoconstric
IV - increased cAMP
What PDE inhibitors are used in COPD?
Theophylline (non-selective)
Rofulimast (PDE IV selective)
to avoid acute exacerbations pt with COPD have
vaccinations
Some emphysema pt have what treatment….
Alpha1 antitrypsin augmentation therapy - if they are deficient, but most patients are not
