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43 Cards in this Set
- Front
- Back
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most effective way to prevent/help copd
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quit smoking
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quick relief meds for copd
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albuterol and ipratropium
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maintenance tx for class 2 and above
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long acting inhaled bronchodilator
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ex of long acting inhaled bronchodilator
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LABA
anticholinergic |
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if the long acting inhaled bronchodilator does work what do you ADD
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if you started w/ tiotropium then add LABA
if you started w/ LABA then start tiotropium |
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if the LABA and tiotropium don't work what do you ADD
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theophylline
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if the LABA and tiotropium and theophylline don't work what do you do
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switch to dual product:
ICS + long-acting inhaled bronchodilator |
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t/f
copd is fully reversible |
f
not fully reversible |
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in copd airflow limitation is usu ------
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progressive
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copd is associated w/ an abnormal ---- response of the lung to ---- particles/gases
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inflammatory
noxious |
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key effector cell in copd
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neutrophil
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what do the neutrophils release
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proteases
which increase secretions and sob |
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the best time to vaccinate
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oct and nov
before the flu season begins |
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name two vaccines that copd pt's should receive
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flu
pneumococcal |
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which copd pts receive short acting bronchodilators
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all pt's
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who receiveds the more long acting bronchodilators
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moderate copd
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when are inhaled glucocorticoids added
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if repeated exacerbatins during severe
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what effectors are involved in asthma
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lymphocytes and eosinophils
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why are asthma pts better off w/ steroids?
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the eosinophils are susceptible to apoptosis
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what do you call eosinophil death
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eosinopenic
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if a pt is on advair and has heart problems would you add another LABA to the course of tx if they were needed an addition
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no
advair already has an BA in it. don't add to the complication. |
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what's in combivent
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albuterol (short acting b agonist)
ipratropium (anticholinergic) |
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which is more advantageous mdi w/ valve holding chamber w/ mask or a nebulizer
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neither, they're botht the same
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when will you give combivent
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when albuterol or ipatro. don't work by themselves
so during moderate |
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why use ab nebulizer
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less expensive
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what do you teach pt's who's using foradil
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open up the device and make sure the capsule is empty
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which is best? formoterol or ipratropium
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formoterol
long acting beta agonist |
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why won't you use ipratropium w/ formoterol for maintenance tx?
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cuz ipratropium is a short acting anticholinergic
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t/f
tiotropium w/ salmetrol is not better than the placebo |
f
it's slightly better |
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is there a big difference btw salmeterol and tiotropium?
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no significance difference
so, the pt should choose if they want to pay less for for salmetrol and if they want to take it 2 x day also consider if the pt has any heart hx |
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which is best for exacerbations: tiotropium w/ salmeterol or tiotropium, salmeterol w/ fluticasone
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tiotropium plus salmeterol plus fluticasone
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why is theophylline w/ salmerterol a bad choice for an elderly pt w/ heart problems
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s/e of thoephylline include tachycardia, increased bp
blood levels should be monitored |
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which is safer Theo or Uniphil?
why |
uniphyl because if taken w/ food its absorption is slowed down
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t/f
pneumonia is a risk factor for pt using inhaled steroids in asthma pt's |
f
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what combo increased chances of pneumonia in pt's
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large dose of advair
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t/f
the large dose of advair decreased mortality rate |
f
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does symbicort show signs of pneumonia
why/why not |
no
possbily because it has a lower dose of budesonide |
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when should advair be rxed
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when the fev is less than 50% and the pt has had 3 exacerbations in 3 years
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t/f
a pt w/ mild copd should received advair over salmeterol first |
f
there might not be much of a difference, plus advair is expensive |
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it a pt is not taking another form of beta agonist what's a good recommendation for a quick relief?
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combivent
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a pt has a hx of heart problems but they need albuterol. what would you recommend?
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a mdi thru valve chamber
decreases systemic absorption |
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what's in combivent
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ipratropium
albuterol |
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when rxing combivent what do you watch out for
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if the pt is alreading taking albuterol. you don't want too much beta agonist that can exacerbate heart problems
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