Slocum Day 1

Question 1

What stages of COPD do you us a PDE4 inhibitor or theophyline

Answer 1

Gold 3 and 4

Question 2

What are 4 things beyond inhalers that can be used for COPD

Answer 2

• antibiotics
• oral coricosteroids
• Methylxanthines
• PDE-4 inhibitor

Question 3

What beyond the inhaler drugs would be usedfor a milder younger patient (FEV1>50 and age <65)

Answer 3

• Doxycycline (Macrolides may be becoming standard)
• Trimethoprin-sulfamethoxazole
• Cepalosporin
• Advanced macrolide (AZITHROMYCIN, clarithromycin)

Question 4

What beyond the inhaler drugs are used for sicker older patients?

Answer 4

• Amoxicillin-cluvulunate

- Fluoroquinilones (watch for achilles rupture)

Question 5

how many days would you give prednisone for

Answer 5

5 days then stop

Question 6

What are the 2 indications for supplemental O2?

Answer 6

1) PaO2 <56 t (mm Hg) or SpO2 <89% measured twice over a 3 week period while at rest
2) PaO2>55 and <60 any time with evidence of
- Pulmonary HTN
- CHF
- Polycythemia Hct >55%

Question 7

Never use these drugs alone in COPD

Answer 7

ICS

Question 8

What does the most for symptom control of COPD

Answer 8

pulmonary rehabilitation

Question 9

All patients who have unexplained dyspnea and cough deserve what?

Answer 9

test for Alpha 1 antitrypsin deficiency