Asthma and COPD

Asthma #1

100

What does SMART stand for?

Symbicort maintainance and reliever therapy

200

According to the 2012 asthma guidelines

A patient must use less than 4 inhalations of their ventolin per week. How many ventolin inhalers should a patient use in a year to still be considered well controlled?

One!

3 x per week multiplied by 52 weeks per year=156 doses

Each ventolin inhaler contains 200 doses

300

What is the maximum number of inhalations of Symbicort daily? How long can a patient stay on the maximum dose?

8 per day/no longer than a week

400

In the compass trial how much ICS was used in the Symbicort smart arm compared to the advair arm and the Symbicort plus Brycanyl arm?

A)25% more

B) 25% less

C) there was no difference

B. Symbicort smart used 25% less ICS

500

In the compass trial comparing the reduction of severe asthma exacerbations of Symbicort maintenance and reliever therapy and advair

What were the results?

A) they were both the same 

B)Symbicort smart reduced exacerbations by 38%more than advair

C) Advair reduced exacerbations by 38% better than Symbicort 

The answer is B!

Symbicort smart reduced asthma exacerbations by 38% compared to advair 

Asthma #2

100

Which asthma medication CAN intervene the EARLIEST when an asthmatic has a worsening ( daytime symptoms, waking up at night etc)

What is symbicort

200

This medication is the most rarely used by the patient during an asthma worsening, yet it is the medication that will blunt an exacerbation from happening.

What is ics

300

Works as fast as ventolin, and therefore has a rescue indication

What is formoterol/oxeze /symbicort Tested vs ventolin in an emergency room setting. Average FEV1 was only 45%. ( Balanag study)

400

This is why using ventolin during an asthma worsening is not the best thing to do

What is does not prevent an exacerbation. It only provides short term relief. It only brings relief for approx 4 hours. The patient actually needs in increase of ICS to settle down the inflammation, and prevent a SEVERE exacerbation. Also, If this inflammation continues, it causes permanent airway remodelling...ie fixed airway disease.

500

The number of days before an exacerbation, where the patient starts to feeling asthma symptoms or rescue use increasing. They may have daytime symptoms, restrict their activities, have nighttime symptoms, lose sleep etc.

What is 10-14 days Tattersfield study

COPD #1

100

When is it appropriate to use an Ics/laba for a copd patient?

When the patient is considered to be moderate to severe and is experiencing 2 or more copd exacerbations per year

200

When a copd patient is hospitalized for a copd exacerbation why is this often referred to as a lung attack?

A) a lung attack has similar mortality and morbidity as a heart attack

B one year after being hospitalized for a copd hospitalization 25% 

C after four years of being hospitalized for a copd exacerbation 50% will die

D all of the above

D all of the above

300

In the pathos study comparing the reduction of copd exacerbations in Symbicort compared to advair

What were the results?

A) Symbicort reduced copd exacerbations by 26% better than advair

B advair reduced copd exacerbations better than Symbicort 

C there was no difference

A Symbicort reduced copd exacerbations better than advair by 26%

400

in copd all ICS/LABA have an increased risk in pneumonia. Are all the ICS’s the same?

Answer yes or no

No.

In the pathos study comparing Symbicort and advair...advair had a 73% higher incidence of pneumonia 

500

In the Pathos study what was the difference in copd hospitalizations with Symbicort compared to advair?

A) the hospitalizations were the same

B) advair had less hospitalizations 

C) Symbicort reduced copd hospitalizations by 29% better than advair

C) Symbicort reduced copd hospitalizations by 29% better than advair

COPD #2

100

What are the two components of Az's new lama/laba called DUAKLIR?

For formoterol + Tudorza (alclidinium)

200

This is the one symptom patients can still have on a LAMA, that could require them to be stepped up to a LAMA/LABA such as Duaklir

What is breathlessness

300

This kind of COPD patient requires a laba/ics ( eg symbicort) if they have ........ ( two things)

What is exacerbations or ACOS

400

There are three main considerations when choosing a LAMA for a patient. They are efficacy, safety and

What is device

500

Each COPD exacerbation will cause the patient's what to decline even further.

What is Lung function

Mixed

100

This is the % of patients who have ACOS?

What is 20-30% These patients will require an inhaled steroid

200

In asthma, Patients tend to use their ventolin when they start to become symptomatic, yet what they really need is an ics to tame the inflammation that is causing the symptoms. These are the three asthma products that Require a ventolin prescribed with them

What is Breo, Advair, zenhale

300

It's Friday night and your asthma patient starts to wheeze from the smoke at a bar. They cough all night and find their symptoms worsening On Saturday. You would like them to have extra ics, but your office is closed until Monday. Which product(s) can the patient safely " take more of" to quickly start to calm the inflammation and get relief? Advair? Breo? Zenhale? Symbicort? Ventolin?

What is symbicort (SMART)

400

Copd exacerbations can be deadly. What % of Copd patients that have been hospitalized for an exacerbation, will be dead in 4 years.

What is 60%. ( higher mortality rate than some cancers)

500

Which is the least expensive treatment option for asthma patients?

What is symbicort smart $101 Symbicort + ventolin $107.25 Breo 100 + Breo 200 + ventolin =$300.25. $142+152+6.25 ( generic)