Term
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Definition
| Progressive, largely irreversible disorder restricts air flow in lungs |
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Term
|
Definition
| abnormal inflammatory response to noxious particles or gases |
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Term
|
Definition
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Term
|
Definition
-Chronic bronchitis (chronic cough, excessive sputum, d/t hypertrophy mucus secreting glands in epithelium of large airways. Lasting 3mths/yr for 2yrs)
-emphysema (enlargement of air space within the bronchioles & alveoli brought on by deterioration of walls of air spaces) |
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Term
|
Definition
| Symptoms of spirometry-measures degree of obstruction. PFTs, ABGs, chest roentgenogram, EKG, hematology, sputum cx, differential dx |
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Term
|
Definition
FEV1 <60% + symptoms
initial monotherapy w/one of: long-acting beta2, tiotropium, inhaled glucocorticoid
-pulmonary rehab
-02
-Nutritional training
-Immunization
-Smoking cessation |
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Term
|
Definition
| selective phosphodiesterase type 4 inhibitor, inactivates cAMP therby decreasing inflammation, cough and mucous |
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Term
|
Definition
| diarrhea, decrease appetite, wt. loss, nausea, HA, back pain, insomnia, depression |
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Term
|
Definition
| Cough, sputum production, dyspnea on exertion, wheezing, poor exercise tolerance |
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Term
|
Definition
| smoking, age, M, existing impaired lung function, occupation, AAT deficiency |
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Term
|
Definition
| air pollution, bronchial reactivity, race, nutritional status, family hx, socioeconomic status, respiratory tract infections |
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Term
|
Definition
| PUlmonary HTN, acute RF, infection, polycythemia |
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Term
|
Definition
| asthma, CHF, bronchiectasis, TB |
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Term
|
Definition
"blue bloaters"
>50 y/o, mild dyspnea w/cough prior, copious purulent sputum, frequent bronchial infection, increased bronchovascular/lg heart on CXR, mod-severe pulmonary HTN at exercise worsens with exercise, cor pulmonale |
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Term
|
Definition
"pink puffers"
>60 y/o, severe dyspnea w/cough following, scanty mucoid sputum, infrequent bronchial infection, increased diameter/flattened diaphragms on chest films, none/mild pulmonary HTN at rest and mod w/exercise, cor pulmonale rare |
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Term
|
Definition
0-IV
based on symptoms and FEV1
FEV1/FVC < 70% in all stages |
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Term
|
Definition
-chronic symptoms (cough & sputum), normal spirometer.
-avoid risk factors, get vaccines (flu) |
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Term
|
Definition
-FEV1 >/80%, w/ or w/o symptoms
-avoid risk factors, vaccine (flu) + short acting bronchodilator PRN |
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Term
|
Definition
| -50%-Avoid risk factors, vaccine (flu), + one or more scheduled long-acting bronchodilator + rehab |
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Term
|
Definition
| -30% -Avoid risk factors, vaccines (flu),+one or more long-acting bronchodilators + rehab + inhaled corticosteroid for repeat exacerbations |
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Term
|
Definition
-FEV1 <30% or FEV1 <50% predicted plus chronic respiratory failure
-Avoid risk factors, vaccines (flu), max bronchodilators + rehab + inhaled corticosteroids for exacerbations + long-term 02 if resp failure + consider sx tx |
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Term
|
Definition
| relieve symptoms, prevent/tx exacerbations, improve health status, improve exercise tolerance, prevent & tx complications, prevent disease progression, reduce mortality |
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Term
|
Definition
| Smooth muscle relax of bronchi, increase ciliary beat, inhibit mast cell degranulation |
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Term
Short acting beta-agonist
COPD |
|
Definition
PRN-monotherapy mild COPD, alleviates symptoms, decreases exacerbation, improves quality of life, response not as significant as in asthma
(Albuterol,Xopenex, Maxair) |
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Term
Long acting beta-agonist
COPD |
|
Definition
More convenient dosing=better compliance, 1-4hrs for effectiveness
(Formoterol, Salmeterol, Arformoterol, indacterol, SR albuterol) |
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Term
Corticosteroids
MOA in COPD |
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Definition
| Bind to glucocorticoid receptors, reduce inflammation, enhance beta-adrenergic receptor expression, decrease mucus production, prevent endothelial and vascular leakage |
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Term
Corticosteroid
indications in COPD |
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Definition
| Alleviates symptoms, reduces exacerbations, improves health status, does not modify airway or alter rate of decline |
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Term
Anitcholinergics
MOA in COPD |
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Definition
Competitvely inhibit cholinergic responses, reduce sputum volume w/o altering viscosity. Best for pts with fixed airway obstruction
(Atrovent, Spiriva, Tudorza) |
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Term
Anticholinergics
Contraindications/cautions |
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Definition
| hypersensitivity, narrow-angle glaucoma, BPH, bladder neck obstruction, acute bronchospasm, impaired renal failure |
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Term
Anticholinergic
side effect |
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Definition
| BUDCAT,angioedema, bronchospasm, pharyngitis, candidiasis |
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Term
Anticholinergic
drug interactions |
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Definition
| Albuterol (+), anticholinergics |
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Term
|
Definition
| COPD exacerbations w/evidence of infection-review antibiogram |
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Term
|
Definition
| Mucolytics, Expectorants, antioxidants, vaccines |
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