Phar 720 Asthma & COPD

Question 1

Short Acting Beta-2 Agonists (SABA) (inhalation)

Answer 1

Albuterol (pro air, ventolin, proventil)

Levalbuterol (xopenex)

Question 2

Albuterol

Answer 2

Proair, ventolin, proventil
Used for asthma, COPD
Usually 1-2 puffs q 4 to 6h prn
Side effects: inc in heart rate possible shakiness, throat irritation

Question 3

Levalbuterol

Answer 3

Xopenex

Question 4

Long Acting Beta-2 Agonists (LABA)

Answer 4

Salmeterol (serevent)

Question 5

Salmeterol

Answer 5

Serevent

Question 6

Corticosteroids (inhalation)

Answer 6

Fluticasone (Flovent)

Budesonide (pulmicort)

Question 7

Fluticasone

Answer 7

Flovent

Question 8

Budesonide

Answer 8

Pulmicort

Question 9

Corticosteroid/LABA’s (inhalation)

Answer 9

Fluticasone/Salmeterol (advair)
Budesonide/formoterol (symbicort)
Mometasone/formoterol (Dulera)

Question 10

Fluticasone/Salmeterol

Answer 10

Advair

Question 11

Budesonide/formoterol

Answer 11

Symbicort

Question 12

Mometasone/formoterol

Answer 12

Dulera

Question 13

Anticholinergics (inhalation)

Answer 13

Tiotropium (spiriva)

Ipatropium (atrovent)

Question 14

Tiotropium

Answer 14

Spiriva

Question 15

Ipatropium

Answer 15

Atrovent

Question 16

Anticholinergic/Beta-2 Agonists (inhalation)

Answer 16

Ipatropium/Albuterol (combivent)

Umeclidinium/vilanterol (anoro ellipta)

Question 17

Ipatropium/Albuterol

Answer 17

Combivent

Question 18

Umeclidinium/vilanterol

Answer 18

Anoro ellipta

Question 19

Anticholinergic/Beta-2 agonists/corticosteroid (inhalation)

Answer 19

Umeclidinium/vilanterol/Fluticasone (trelegy)

Question 20

Umeclidinium/vilanterol/Fluticasone

Answer 20

Trelegy

Question 21

Name COPD

Answer 21

Chronic obstructive pulmonary disease

Question 22

Name PEF

Answer 22

Peak expiratory flow

Question 23

FEV1

Answer 23

Forced expiratory volume at 1 second

Question 24

FVC

Answer 24

Forced vital capacity

Question 25

SABA

Answer 25

Short acting beta2 agonist

Question 26

LABA

Answer 26

Long acting beta2 agonist

Question 27

LAMA

Answer 27

Long acting muscarinic agonist

Question 28

SAMA

Answer 28

Short acting muscarinic agonist

Question 29

ICS

Answer 29

Inhaled corticosteroid

Question 30

Define asthma

Answer 30

Inflammation and bronchoconstriction of lungs (narrows airway)

Question 31

Atopic asthma

Answer 31

Allergen sensitization Most common Positive family history IgE meditated: elevation of immunoglobulin E

Question 32

Non-atopic asthma

Answer 32

Non allergic | Positive family history less common

Question 33

Exercised induced bronchoconstriction

Answer 33

Type of asthma, worsens in cold and dry climate

Question 34

Drug induced asthma

Answer 34

Inhibit cyclooxygenase pathway (aspirin, NSAID’s are common triggers)

Question 35

Occupational asthma

Answer 35

Exposure to fumes, chemical dusts

Question 36

Risk factors for asthma

Answer 36

Allergies=>IgE mediated response to common allergens Viral infections=> can trigger an inflammatory response Eczema=> inflammation of skin can spread to lungs Occupational exposures Obesity=> fat is involved in inflammatory pathways Family history Air pollution

Question 37

Common Asthma Triggers

Answer 37

``` Genetics Pollution Cigarettes Perfumes and cosmetics Cold air/changes in weather Pets Dust, pollen and cockroaches Drugs, aspirin, NSAIDS ```

Question 38

Symptoms of asthma

Answer 38

Wheezing Shortness of breath Cough Chest tightness

Question 39

Signs of asthma

Answer 39

Decreased peak expiratory flow (PEF)=> lung function Increased heart rate Increased respiratory rate Low blood pressure

Question 40

Pulmonary function tests

Answer 40

Spirometry: device to test lung function FEV1: how much air can be forcefully exhaled in one sec FVC: after taking a deep breath, the maximum volume of air that is exhaled FEV1/FVC: percentage of total air capacity that can be forcefully exhaled in one sec

Question 41

What are the 2 types of asthma drugs

Answer 41

Relievers/rescue drugs: rapidly open airways within minutes | Controllers/maintenance drugs: taken daily to reduce inflammation, maintain asthma control

Question 42

What rescue meds are the first line of treatment?

Answer 42

SABA: relax bronchial smooth muscle in 3-5 min LABA: inhibit inflamm. Response,block reactions to allergens, reduce airway hyperresponsiveness *ICS+ formoterol can be used as a reliever or for maintenance Anticholinergic: block parasympathetic nerve reflexes which cause airway constriction *usually used with SABA

Question 43

Controller meds for asthma

Answer 43

Inhaled corticosteroids (ICS):anti-inflammatory LABA: Used in combo with ICS *never used alone ICS+formoterol can be used as reliever or maintenance Leukotrine receptor antagonist (LTRA): targets one of the inflammatory pathways

Question 44

Additional/last resort therapies

Answer 44

Long acting muscarinic antagonists (LAMA): used as an add on in pts w/ a history of exacerbations despite’s ICS/LABA treatment Anti-IgE: for severe allergic asthma uncontrolled by ICS/LABA *only used in a healthcare setting under supervision Methylxanthine: alternative bronchodilator when not responding to other treatments

Question 45

Ex. Of Anti-IgE med

Answer 45

Omalizumab (injection)

Question 46

Ex. Of Methylxanthine med

Answer 46

Theophylline

Question 47

What does GINA stand for and what is it?

Answer 47

Global initiative for asthma guidelines. It is a resource for guiding the start of treatments from assessments of a pt

Question 48

What is COPD

Answer 48

Causes obstructive airflow to lungs Most commonly due to chronic bronchitis and/or emphysema It is chronic and irreversible

Question 49

Bronchitis

Answer 49

Inflammation and excess mucus in the bronchioles

Question 50

Emphysema

Answer 50

Alveolar sacs become destroyed. Creates a lack of exchange of oxygen

Question 51

#1 cause o COPD?

Answer 51

Cigarette smoke

Question 52

COPD risk factors

Answer 52

``` Tobacco smoke Alpha-1 antitrypsin (ATT) deficiency: protein made in liver to protect lungs from inflammation Asthma: can lead to COPD Exposure to particles Older age Socioeconomic status ```

Question 53

Symptoms of COPD

Answer 53

Coughing/wheezing Excess phlegm,mucus, or sputum production SOB Trouble with deep breaths

Question 54

Signs of COPD

Answer 54

Decline in PEF and FEV1 (FEV1/FVC < 0.7 confirms diagnosis) Inc. heart rate & resp. Rate Pulmonary hypertension Signs of right sided heart failure Pursed lip breathing Lips or fingernails are blue or gray in color

Question 55

What is GOLD guidelines

Answer 55

Global initiative for chronic obstructive lung disease guidelines Classifies and assesses COPD to direct treatment

Question 56

*** Go over guidelines assessment tool

Answer 56

Yes sir

Question 57

Define displeasure

Answer 57

SOB

Question 58

What is mMRC used to do?

Answer 58

Assesses breathlessness => a survey pts fill out

Question 59

What is CAT?

Answer 59

Assess impact of COPD on pt health, a form pt fills out

Question 60

COPD vs. Asthma

Answer 60

Age of onset: COPD over 40, asthma under 40 Smoking history: COPD over 10 years, asthma uncommon Sputum production: COPD more common, asthma less common Allergies: COPD uncommon, asthma common Disease process: COPD progressive, worsens over time, asthma stable, does not worsen overtime Exacerbations: COPD common complication, asthma common complication Preferred medication: COPD LAMA,asthma corticosteroids