treatment options for COPD

Question 1

What are the treatment options for COPD?

Answer 1

• Stop smoking – slows COPD progress
• Immunization against infections
• Glucocorticoids largely ineffective (unless asthma already present) – unclear why
• Long acting bronchodilators – modest benefit but no effect on inflammation (help them to breath easier but dont prevent the disease progressing)
• Long-term oxygen therapy

Question 2

What is a Cough?

Answer 2

Protective reflex removing foreign material /secretions

Question 3

What are the two types of Cough?

Answer 3

• Productive (removes sputum from lungs)

- Dry ( no removal of sputem)

Question 4

What is the treatment for a dry cough?

Answer 4

Anti-tissuves

Question 5

What are the 3 types of Anti-tissuves?

Answer 5

• Opioids
• Demulcents
• Local anaesthetics

Question 6

What is the mechanism of action of opioids?

Answer 6

• Opioid analgesics acting on poorly defined “cough centre” in brain
• Act on mu-opioid receptors

Question 7

Give examples of 3 Opioids

Answer 7

Codeine

Dextromethorphan / pholcodine

Morphine

Question 8

Side effect of codeine?

Answer 8

constipation

Question 9

side effect of Dextromethorphan / pholcodine?

Answer 9

promotes respiratory depression

Question 10

When are the anti-tissuves Demulcents used clinically?

Answer 10

For coughs originating above the larynx

Question 11

What is the mechanism of action of Demulcents?

Answer 11

Form a protective coating over the irritated pharyngeal mucosa.

Question 12

How are Demulcents given?

Answer 12

Given as syrups or lozenges

Question 13

Give examples of local anaethetics

Answer 13

• Lidocaine
• Benzocaine
• Hexylcaine hydrochloride
• Tetracaine

Question 14

What do local anaesthetics do?

Answer 14

Inhibit the cough reflex under special circumstances (e.g., before bronchoscopy or bronchography).

Question 15

What is used to treat productive coughs?

Answer 15

Expectorants

Question 16

How do Expectorants function?

Answer 16

• Expel bronchial secretions from the respiratory tract by decreasing broncial secretion viscosity.
• Increasing respiratory tract fluid / exert a demulcent action on the mucosal lining.
• Increase secretions through reflex irritation of the bronchial mucosa.
• Iodides, also act directly on the bronchial secretory cells and are excreted into the respiratory tract.

Question 17

Give examples of two Expectorants

Answer 17

Guaifenesin (most commonly used expectorant in cough remedies)

Iodides

Question 18

Guaifenesin side effects

Answer 18

No serious adverse effects but no clear evidence of its efficacy.

Question 19

What is the mechanism of action of Iodides?

Answer 19

liquefy tenacious bronchial secretions (e.g., in late stages of bronchitis).

Question 20

What types of iodides are used?

Answer 20

• Saturated solution of potassium iodide least expensive, most commonly used
• Iodinated glycerol is better tolerated than potassium iodide solution but less effective.

Question 21

What are the side effects of Iodides?

Answer 21

Low patient acceptance due to unpleasant taste

side effects

• acneiform skin eruptions
• painful swelling of the salivary glands

Side effects are reversible and subside when the drug is stopped.

Prolonged use of iodides or iodinated glycerol can lead to hypothyroidism.