Exacerbations
What is a COPD exacerbation?
What is an acute event with increased dyspnea and/or cough and sputum that worsens in <14 days?
In the context of spirometry, this specific parameter represents the total volume of air a patient can forcibly exhale from their lungs after taking the deepest breath possible
What is Forced Vital Capacity (FVC)?
Patient DT is a 63 y/o F that presents to your clinic for evaluation of a chronic cough, expressing concern for COPD due to her past history of smoking (has quit for about 20 years). Her home medications include rosuvastatin 20 mg, lisinopril 40 mg, escitalopram 10 mg, and Vitamin C 500 mg. What could be a causative agent for DT's chronic cough?
What is lisinopril?
This short-acting beta-2 agonist (SABA) is the most common "rescue" inhaler used as needed to provide quick relief from acute symptoms like wheezing and breathlessness
What is albuterol?
What is the #1 risk factor for COPD?
What is tobacco smoking?
What treatment is used for mild COPD exacerbations
What is SABDs?
List one appropriate treatment for newly-diagnosed COPD patients in the Group A category.
This device can aid patients with poor motor coordination to improve metered-dose inhaler (MDI) technique.
What is a spacer?
Dry mouth and a bitter or metallic taste are the most common side effects associated with this class of bronchodilators, which includes drugs like tiotropium and umeclidinium
What are LAMAs?
Initial COPD diagnoses are staged using the following ratio:
*DAILY DOUBLE: what numerical threshold must meet in order classify a patient with COPD?
What is FEV1/FVC?
Bonus: <0.7
What is purulent sputum, increased dyspnea, increased sputum volume, mechanical ventilation, prior positive sputum bacteria culture?
What is the difference in initial treatments for COPD patients in Group A versus Group B?
What is 'a bronchodilator' versus 'LABA + LAMA'
You are a TOC pharmacist counseling patient JG on a new inhaler called Advair Diskus. How should you tell the patient to inspire this medication?
(Of note Advair Diskus is a DPI)
What is quick, forceful inhalation?
What is a key counseling point for patients using an inhaled corticosteroid (ICS)?
What is rinse mouth with water and spit after inhalation?
A person with COPD may be staged as GOLD-3 (severe) if their FEV1 is _ - _ % of their predicted value
What is 30-49% ?
Following a COPD exacerbation, the GOLD guidelines recommend waiting this specific amount of time before re-measuring spirometry to assess the patient’s stable baseline lung function.
What is 12-16 weeks?
While the CAAT questionnaire assesses a broad range of symptoms, this simpler, one-question assessment tool (scored 0 to 4) is used exclusively to determine how much physical activity a patient can tolerate before becoming breathless.
What is the mMRC (Modified MRC Dyspnea Scale)?
Patient SS is a newly-diagnosed COPD patient with an mMRC score of 3, CAAT score of 20, and zero exacerbations in the past year. Name one appropriate drug therapy for initial management.
What is Duaklir, Bevespi Aerosphere, Anoro Ellipta, Stiolto Respimat?
What is the brand name of tiotropium?
What is Spiriva Respimat, Spiriva HandiHaler?
To be eligible for this oral PDE-4 inhibitor, a patient must meet three specific criteria: a history of frequent exacerbations, an FEV1 < 50%, and a history of chronic bronchitis
What is rofumilast (Daliresp)?
A moderate COPD exacerbation is classified as having at least 3 of the 5 following symptoms:
What is dyspnea VAS ≥ 5, RR ≥ 24 breaths per min, HR ≥ 95 bpm, CRP ≥ 10 mg/L, resting SaO2 <92 on ambient air and/or change >3% when known
Patient MJ presents with an FEV1 that is 65% of predicted, an mMRC score of 3, CAAT score of 6, and zero exacerbations in the last year, placing him in this specific GOLD Grade and treatment group.
What is Gold 2, Group B?
Patient LJ is a 41 y/o M with PMH of chronic bronchitis and COPD who will be discharged from WFBH after experiencing his second severe COPD exacerbation this year. His most recent maintenance therapy was a triple-therapy combination product called Trelegy Ellipta (vilanterol + umeclidinium + fluticasone furoate). L. James's eosinophil count today was 455 cells/ul. What new maintenance therapy could be considered for LJ?
What is dupilumab, mepolizumab?
Approved in 2024, this first-in-class nebulized therapy for persistent dyspnea works through a dual mechanism, inhibiting both the PDE-3 and PDE-4 enzymes to provide direct bronchodilation and anti-inflammatory effects
What is ensifentrine (Ohtuvayre)?
The GOLD guidelines recommend this vaccination as a 'one and done' vaccine for COPD patients, who are prone to having an increased risk for pneumococcal infections.
What is PCV20 or PCV21?