Respiratory Flashcards
COPD spirometry?
<0.7 and persistent
Goals of therapy for COPD?
improve exercise and IDLs and lower symptoms and exacerbations
Explain GOLD classifications?
1: FEV1 >0.8
2: FEV1 0.5-0.8
3: FEV1 0.3-0.5
4: <0.3
What is MRC scale?
1: only breathless with strenuous
2: SOB up hill
3: walk slower and have to stop
4: stop after 100 m
5: cant leave house
Which is better LABA or LAMA?
LAMA lowers exacerbations more
Issues with ICS in COPD?
increases pneumonia risk
Is triple therapy more efficacious than double?
DUH
Patient comes in has 1 moderate exacerbation (no hospital) and only gets breathless going up hills what therapy?
only bronchodilator or SABA/SAMA
Patient comes in has 1 severe exacerbation (hospital) and gets breathless after 100 m what therapy?
LABA+LAMA maybe ICS
Patient comes in has 1 moderate exacerbation (no hospital) and gets breathless after 100m what therapy?
LABA+LAMA
Patient comes in has 1 moderate exacerbation (hospital) and only gets breathless going up hills what therapy?
LABA+LAMA maybe ICS
When do we add ICS to therapy?
if eosinophils >300, or exacerbation or at risk of exacerbation, or co asthma
S/e of ABA?
high HR, BP, jittery
S/e of AMA?
dry mouth, constipation
What inhaler if weak lungs and weak hands?
genuair
What inhaler if strong lungs and weak hands?
turbuhaler, diskus, ellipta, genuair
What inhaler if weak lungs and strong hands?
breezhaler, Handihaler, genuair, MDI, Respimat
What inhaler if strong lungs and strong hands?
any inhaler
How to get EDS for dual or triple therapy?
failure of mono and then failure of double
Comorbid conditions in COPD?
HF, GERD, osteoporosis, depression
What meds should we avoid in COPD?
non selective BB, benzo, anticholinergics
What is a COPD exacerbation?
worsening >48 hours
What alteration of treatment in COPD exacerbations?
schedule SABA
O2
prednisone 30-50 mg daily
What individuals are high risk of antibiotic failure in AECOPD?
FEV1 <50%, CAD, chronic oral CS use, >4 exacerbations/year, home O2, antibiotics last 3 months
