PHARM - Drugs Affecting the Respiratory System: COPD - Week 7 Flashcards

1
Q

Define COPD.

A

Chronic obstructive pulmonary disease - a group of disorders characterised by airway inflammation and airflow limitation that is not fully reversible.

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2
Q

Are COPDs preventable and/or curable?

A

Almost completely preventable but completely incurable.

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3
Q

Compare death rates for coronary heart disease, stroke, CVDs, and other causes compared to COPDs.

A

All are on the decline for the past 50 years except COPD which is on a sharp incline.

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4
Q

What population is at the higher risk of COPDs? Name 6 additional risk factors for the development of COPDs.

A

Ageing populations
-cigarette smoke
-occupational dust/chemicals
-environmental tobacco smoke
-indoor/outdoor air polution
-genetics
-infections

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5
Q

What is FEV1 and what happens to it with age?

A

It is the amount of air you can forcefully exhale in one second. It naturally declines with age.

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6
Q

How does smoking and quitting smoking affect FEV1? Is there any known cure for this effect?

A

There is a more rapid decline in FEV1 when smoking. Quitting smoking will slow down its progression, but it will not return to normal age-matched levels.
There is no known cure to restore normal levels.

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7
Q

Are COPDs acute or progressive?

A

Progressive

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8
Q

What kind of response do lungs have with COPDs and to what?

A

Inflammatory response of the lungs to noxious particles and gas

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9
Q

What is the major risk factor for COPDs and what percentage of cases is it responsible for?

A

Smoking, which is responsible for 80-90% of cases

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10
Q

What three components form the diagnosis of COPD?

A

Spirometry
Clinical symptom assessment
Exacerbation history

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11
Q

After a noxious agent causes inflammation in the lungs, describe four outcomes of this and what it leads to.

A

Airway inflammation
Airway remodelling
Loss of alveolar attachments
Decrease of elastic recoil
Collectively this causes airflow limitations

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12
Q

What three diseases are encompassed by COPDs? Do most patients have 1, 2 or 3 of these diseases?

A

Chronic obstructive bronchiolitis
Chronic bronchitis
Emphysema
Most patients have all three

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13
Q

Briefly describe chronic obstructive bronchiolitis (2).

A

Fibrosis and obstruction of small airways

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14
Q

Briefly describe chronic bronchitis (2).

A

Mucus plugging and coughing

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15
Q

Briefly describe emphysema (4).

A

Enlargement of airspaces
Destruction of lung parenchyma
Loss of lung elasticity
Closure of small airways

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16
Q

Consider the small airways of someone with COPD. What is the diameter like during inspiration and expiration? What two things does this eventually result in (4)

A

Inspiration - thickened airway with a far smaller diameter compared to normal
Expiration - airway closure
This leads to air trapping and hyperinflation.
Eventually this causes dyspnoea and decreased exercise tolerance.

17
Q

What immune cells (4) and what enzyme is responsible for the cellular mechanisms of COPDs? What do they cause?

A

Macrophages, T cells, neutrophils, and monocytes, as well as proteases. Cause mucus hypersecretion.

18
Q

What three factors can exacerbate COPDs?

A

Bacteria
Viruses
Pollutants

19
Q

What are the three aims of treating COPDs?

A

Symptom relief
Improvement of exercise tolerance
Prevention or treatment of exacerbation/complications

20
Q

What are 5 non-pharmacological options for treating COPDs?

A

Stop smoking
Manage/minimise impact of co-morbidities
Pulmonary rehabilitation
Lung volume reduction surgery
Oxygen therapy

21
Q

What is the addicting component of smoking?

A

Nicotine

22
Q

What effect can nicotine have on the body and why will some people continue smoking because of this?

A

Major appetite suppressant
Many will continue to smoke to control weight

23
Q

Name 5 possible pharmacological therapies for COPDs.

A

Bronchodilators
Glucocorticoids
Methylxanthines
Antibiotics (if infected)
Vaccines (pneumococcal/influenza)

24
Q

Name 2 adverse effects of using bronchodilators.

A

Muscle tremors
Tachycardia/palpations

25
Q

How are glucocorticoids administered to treat COPDs?

A

Inhaled

26
Q

Do clucocorticoids affect the progression of disease?

A

No

27
Q

What are glucocorticoids used to treat COPDs associated with?

A

Increased risk of pneumonia.

28
Q

When are methylxanthines used?

A

Severe COPD

29
Q

Can glucocorticoids be used chronically or short-term?

A

Short term only, chronic use should be avoided

30
Q

What are 2 limitations of glucocorticoids?

A

Resistance
Unfavourable benefit/risk ratio

31
Q

List the treatment options that have a significant effect on COPD progression.

A

None

32
Q

What is the mainstay of COPD treatment?

A

Long-acting bronchodilators

33
Q

Differentiate between COPD and athsma in terms of causes.

A

Athsma is caused by an allergen
COPDs are caused by noxious agents like cigarette smoke

34
Q

Differentiate between COPD and athsma in terms of immune cells involved (3 each).

A

Athsma involve mast cells, eosinophils, and CD4+ cells
COPDs involve macrophages, CD8+ cells, and neutrophils

35
Q

Differentiate between COPD and athsma in terms of what happens to the lungs.

A

Athsma results in bronchoconstriction and AHR
COPDs involve small airway narrowing and alveolar destruction

36
Q

Differentiate between COPD and athsma in terms of reversibility.

A

Athsma is reversible
COPDs are irreversible