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3.0 Respiratory system > COPD > Flashcards

Flashcards in COPD Deck (15)
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1
Q

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe which progressive lung diseases? (3)

A

1) Emphysema
2) Chronic bronchitis
3) Refractory (non-reversible) asthma

2
Q

what is the main risk factor for the development of COPD?

A

Smoking - Smoking cessation reduces the progressive decline in lung function

3
Q

Infection can complicate COPD, how can this be prevented?

A

vaccination:

1) pneumococcal vaccine
2) influenza vaccine (free)

4
Q

what should be trialed in patients with moderate or severe airflow obstruction if the diagnosis is in doubt?

A

high-dose ICS or an oral corticosteroid

5
Q

Symptoms of COPD may be alleviated by an inhaled SABA or a SAMA used as required. when should regular inhaled therapy be used?

A

When the airways obstruction is more severe. (important to check compliance and inhaler technique before initiating a new drug)

6
Q

1) If FEV1 is ≥ 50% of predicted what drugs should be started in COPD and what drugs be discontinued?
2) what is the next step if the patient experiences persistent exacerbations or breathlessness?

A

1)► exacerbations/breathlessness: Either a LABA or LAMA

↳ SAMA should be discontinued when a LAMA is started

b) A LABA + ICS in a combination inhaler can be used for patients who remain symptomatic despite regular treatment with a LABA
3) ►persistent exacerbations/breathlessness: Triple therapy with LABA + ICS in a combination inhaler + a LAMA should be used.

7
Q

1) If FEV1 is ≤ 50% of predicted, what drugs should be prescribed in COPD and what drugs should be discontinued?
2) what if the patient continues to remain symptomatic?

A

1) ► exacerbations/breathlessness: Either a LAMA OR LABA + ICS in a combination inhaler should be used.

↳ Discontinue SAMA if LAMA started

2)► Persistent exacerbations/breathlessness: Triple therapy with LABA + ICS in a combination inhaler + a LAMA should be used.

8
Q

If FEV1 is ≤ 50% of predicted and an ICS is inappropriate, what combination of drugs can be used in exacerbations or persistent breathlessness of COPD?

A

LABA with an LAMA

9
Q

when would oral M/R aminophylline or theophylline be used in COPD?

A

if a person with stable COPD is still symptomatic after a trial of short-acting and long-acting bronchodilators (with or without inhaled corticosteroids), or cannot use inhaler devices successfully

10
Q

what class of drug is Indacaterol, and what is it licensed to treat?

A

LABA - licensed for the maintenance treatment of COPD

11
Q

1) name TWO mucolytics used in COPD
2) when would a mucolytic be considered in COPD?

A

1) Carbocisteine and acetylcysteine- licensed for COPD
2) in a patient with a chronic productive cough

12
Q

what is the benefit of using long term oxygen therapy in COPD?

A

prolongs survival in patients with severe COPD and hypoxaemia

13
Q

How should a person with an acute exacerbation of COPD be treated? (3)

A

1) Bronchodilator can be administered through a nebuliser if necessary and oxygen given if appropriate

↳Aminophylline IV if response to bronchodilators is poor

2) Prescribe prednisolone 30 mg once daily for 7-14 days, if increased breathlessness interferes with daily activities
3) Prescribe oral antibiotics for people with purulent sputum or clinical signs of pneumonia.

↳ Amoxicillin 500 mg TDS for 5 days (alternatives doxy or claritho)

14
Q

what should be given to patients who have an episode of hypercapnic respiratory failure?

A

24% or 28% Venturi mask and an oxygen alert card endorsed with the oxygen saturations required during previous exacerbations

15
Q

what should be considered in COPD patients requiring frequent courses of oral corticosteroids (3–4 courses per year)

A

Consider osteoporosis prophylaxis