Pharm of COPD - Fitzpatrick Flashcards

1
Q

COPD is characterized by disruption of _____

A

Alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Major immune cell players for COPD vs. asthma

A
COPD = CD8+, neutrophils, macrophages
Asthma = CD4+, eosinophils
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Compared to asthma, COPD is less responsive to ______

A

Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Compared to asthma, airway flow limitation in COPD is ______

A

Irreversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Compared to asthma, nearly all of COPD patients are ______

A

Smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Symptoms of COPD not included in asthma

A
  • Chronic, productive cough

- Persistent, progressive breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of asthma not included in COPD

A
  • Nocturnal breathlessness

- Day-to-day variation in symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In COPD, the primary way to dilate the bronchioles is via ______

A

Muscarinic antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Muscarinic (M1-3) antagonist drugs in COPD (2)

A
  • Ipratropium

- Tiotropium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In COPD, the primary way to pharmacologically diagnose the disease is via _____

A

Muscarinic agonism (Methacholine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What nerve innervates the SM of the airways, and is thus the target for COPD therapy?

A

Vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What 2 things are targeted in the airways by anti-COPD treatments?

A
  • Pulmonary smooth muscle

- Mucus glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Differences between Ipratropium and Tiotropium

A

Ipra - short acting, 3-4x per day, includes M2

Tio - long acting, 1x per day, M1 and M3 only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

COPD treatments DO _____, but do NOT ____

A
  • DO decrease symptoms, exacerbation, etc.

- Do NOT halt long-term progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

4 “Gold Stages” of COPD

A
  1. Intermittent symptoms
  2. Persistent symptoms
  3. Frequent exacerbations
  4. Respiratory failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of Stage 1 COPD

A

Short acting drugs…

- Ipratropium, albuterol, or both

17
Q

Treatment of Stage 2 COPD

A

Long acting + short acting…

- Tiotropium + albuterol (+ Salmeterol or Formoterol)

18
Q

Treatment of Stage 3 COPD

A

2 Long acting drugs…

- Tiatropium + Salmeterol/Formoterol

19
Q

Treatment of Stage 4 COPD

A

Long acting + ICS…

  • Tiatropium
  • Budesonide + Formoterol (typical combo)
  • Fluticasone + Salmeterol (typical combo)
20
Q

Can Ipra and Tio be used in asthma?

A

Yes, but not as effective as beta-2 agonists

- Used if patient does not tolerate or respond to SABA/LABA

21
Q

Chronic treatment with ____ should be avoided at all costs

A

Systemic glucocorticosteroids

22
Q

What miscellaneous asthma drug can also be used for COPD if warrented?

A

Theophylline

23
Q

3 points of advice for COPD patients

A
  1. Get a flu shot every year
  2. Get the pneumococal vaccine
  3. Avoid crowds and sick people
24
Q

Can SABAs and LABAs be used in COPD?

A

YES

25
Q

Which drug class for asthma has NO ROLE in COPD?

A

LT modifiers