Pulmonary Conditions & Tobacco cessation: COPD Flashcards
people with what deficiency are at higher risk of developing COPD?
AAT = alpha 1 antitrypsin deficiency
Post-bronchodilator FEV1/FVC of what confirms COPD?
< 0.70
GOLD system COPD
stages 1-4
used to assess prognosis and disease progession
GOLD 1
Mild
FEV1 > 80%
GOLD 2
Moderate
50% - 80% FEV
GOLD 3
Severe
30% - 50% FEV
GOLD 4
Very severe
< 30% FEV
Most common scoring systems for COPD
mMRC
CAT
What is COPD exacerbation
increase in respiratory symptoms that worsen over < 14 days
How many exacerbations per year are considered frequent?
2
ICS is recommended in patients with,….
Eosinophil count > 300
and history of exacerbations
ICS is not recommended in patients with
Eosinophil count < 100
CAT score > 10, mMRC > 2 then…
group B
CAT score < 10, mMRC < 0-1 then….
Group A
> 2 moderate exacerbations or > 1 leading to hospitalization then…
Group E
Group A initial treatment
Bronchodilator
SAMA PRN, SABA PRN, LAMA or LABA
Group B initial treatment
LAMA + LABA
Group E initial treatment
LAMA + LABA
+ ICS if eosinophils > 300
When should antibiotics be used?
if increased sputum purulence, volume or dyspnea, or if on technical ventilation
SAMA (short acting muscarinic antagonists) drugs
Ipratropium = Atrovent
SAMA & LAMA side effects
Dry mouth
Cough
Bitter Taste
SAMA & LAMA warnings
caution in pts with narrow angle glaucoma, myasthenia graves, urinary retention, mph and bladder neck obstruction
LAMA (long muascarinic antagonists) drugs
Tiotropium = Spiriva
umeclidinium = incruse ellipta
LABA can be used as mono therapy in which disease state?
COPD
For ICS containing LABA, it is important to
rinse mouth after use to prevent candidiasis
Roflumilast CI
moderate to severe liver impairment
Roflumilast side effects
Diarrhea
weight los
nausea
dec appetite
insomnia
HA
