List the treatment goals for reducing symptoms of COPD:

List the treatment goals for reducing risk of COPD:

How may dyspnea present in a person w/ COPD?

How may chronic cough present in a person w/ COPD?

On physical exam, what may be observed in a pt with COPD?

T/F: Smoking cessation is the interventions with the least capacity to influence the natural history of COPD

How do you determine pack year history?

First line agents for smoking cessation

T/F: All smokers should be offered smoking cessation counseling at every visit.

List the 5 As for smoking cessation strategy:

T/F: No medications alter LT decline of COPD or reduce mortality

Therapeutic agents for stable COPD

First line for category C:

First line for category A

First line for category D:

First line for category B:

List the 3 components of the COPD management cycle

In the COPD management cycle, what are we reviewing?

In the COPD management cycle, what are we assessing?

In the COPD management cycle, what are we adjusting?

Meds that increase FEV₁ by altering airway smooth muscle:

T/F: Bronchodilators do all of the following:

• Improves lung elastic recoil
• Helps empty lungs of air
• Decreases hyperinflation and rest and during exercise
• Improves exercise tolerance

SABAs last how long?

LABAs last how long?

T/F: The use of routine SABAs with LABAs should be avoided

AEs of β2 agonists:

T/F: LABAs have been shown to:

• Improve FEV1, lung vol, and QoL
• ↓ SOB and exacerbations
• No impact on LT lung decline or mortality

Examples of SABAs:

Examples of LABAs:

Which LABAs are dosed BID?

Which LABAs are dosed daily?

Which LABA(s):

• Significantly improve FEV₁ and lung volumes, dyspnea, health related QoL, and exacerbation rate
• No effect on rate of decline of lung function or mortality

Which LABA(s):

• Bronchodilator effect is significantly > Salmeterol and Formoterol
• Significant effects on breathlessness, health status, and exacerbation
• Cough noted following inhalation

______________ inhalers block muscarinic receptors in bronchial smooth muscle causing bronchodilation

SAMAs last how long

LAMAs act how long:

Most studied anticholinergic:

AEs of anticholinergics

Ipratropium is a _______ (SAMA/LAMA)

Ipratropium dosing

LAMAs w/ q day dosing:

LAMAs w/ BID dosing:

Which medication is less effective and less well tolerated than LABAs that must be routinely measured and within therapeutic range?

AEs of Theophylline:

Pt education for theophylline:

Examples of combo bronchodilators:

T/F: Role of corticosteroids is controversial bc efficacy varies pt to pt, and withdrawal from the treatment could lead to exacerbation

AEs of corticosteroids:

Pt education for corticosteroids:

Examples of inhaled corticosteroids:

T/F: ICS+LABA combo therapy is more effective than either individual component

Elderly pts may have difficulty with:

Example of PDEi

T/F: Roflumilast may or may not be used in conjunction w/ a bronchodilator

Roflumilast is dosed ______ (BID/Daily)

AEs of Roflumilast

Roflumilast should be avoided in pts w/ significant ________ dysfxn

T/F: Roflumilast does not treat bronchospasm

Roflumilast is indicated for pts in which grade(s) (ABCD) as an alternative choice?

Roflumilast reduces exacerbations in pts treated w/ corticosteroids by _______%

T/F: Regular use of antibiotics may reduce exacerbation risk

T/F: Moxifloxacin was shown to reduce exacerbations in pts prone to exacerbations in a study that dosed it at 250 mg/day or 500 mg 3x/wk for 1 year

Which vaccine can decrease infections, hospitalizations and mortality in COPD pts?

Which vaccine is indicated for all pts 65 and older or w/ significant CV dz that reduces CAP for pts w/ an FEV₁ <40%?

T/F: Mucolytics (Carbocysteine and N-acetylcysteine) may reduce exacerbations in pts not receiving ICS

T/F: The regular use of cough suppressants is recommended in COPD pts because coughs do not serve a protective fxn and should be kept to a minimum

Non-pharm trtmt:

T/F: LT admin of O2 (>15 hr/d) in pts w/ chronic respiratory failure increases survival

Most common risk factor for acute exacerbations:

Prevention of exacerbation:

T/F: Acute exacerbations are based entirely on the clinical presentations of the pt (i.e. cough, dyspnea, sputum production) and there are no labs or biomarkers to confirm diagnosis

Most common bacteria in severe COPD

Signs of severity of exacerbations:

Factors favoring hospitalization for Trtmt of COPD exacerbation:

Mild exacerbation should be treated w:

Moderate exacerbation should be treated w:

Severe exacerbation should be treated w: