Resp: Treatment of COPD

Question 1

What do M1, M2 and M3 muscarinic receptors each regulate?

Answer 1

M1- ACh transmission
M2- Ach Inhibition
M3- Bronchoconstriction + mucus secretion

Question 2

Which muscarinic receptors are targeted in the treatment of COPD?

Answer 2

M1 and M3- M2 receptors have a beneficial effect by reducing release of ACh

Question 3

Give an example of a SAMA

Answer 3

Ipratropium

Question 4

Give an example of a LAMA

Answer 4

Tiotropium

Question 5

Which drug is superior out of Ipratropium and Tiotropium and why?

Answer 5

Tiotropium as it has a longer half life at M3 receptor

Question 6

Which drugs combined are most effective at increasing FEV1?

Answer 6

LABA + LAMA

Question 7

What is rofumilast an example of?

Answer 7

A PDE4 inhibitor

Question 8

What are the beneficial effects of rofumilast?

Answer 8

Suppresses inflammation and emphysema

Question 9

What are the adverse effects of Rofumilast?

Answer 9

Nausea, diarrhoea, headache, weight loss

Question 10

Give an example of a mucolytic drug

Answer 10

Carbocisteine

Question 11

What action to mucolytic drugs have?

Answer 11

They reduce sputum viscosity

Question 12

Which drug is given for mild COPD?

FEV1 > or equal to 80%

Answer 12

SAMA e.g Ipratopium

Question 13

Which drugs are given for moderate COPD?

FEV1 between 50-80%

Answer 13

SAMA, LAMA + LABA

Question 14

Which drugs are given for severe COPD?

FEV1 between 30-80%

Answer 14

SAMA, LAMA, LABA + ICS

Question 15

How is an acute exacerbation of COPD managed

Answer 15

ISOAP
Ipratropium nebulised
Salbutamol nedbulised
Oxygen 24%
Antibiotics if sputum purulent (amoxicillin) 
Prednisolone (40mg orally)