Bronchodilators in COPD

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Questions and Answers

Which bronchodilator was found to be more effective in relieving dyspnea and had a quicker onset of action compared to ipratropium bromide in a study?

  • Terbutaline
  • Albuterol (correct)
  • Salbutamol
  • Fenoterol

Which short-acting beta2-agonist was taken off the market in many countries due to its adverse effects on the heart?

  • Ipratropium bromide
  • Terbutaline
  • Salbutamol
  • Fenoterol (correct)

Which class of medication is recommended for all stages of COPD?

  • Short-acting beta2-agonists (correct)
  • Anticholinergics
  • Methylxanthines
  • Long-acting beta2-agonists

Which bronchodilator has shown some benefit in bronchodilation and dyspnea for stable COPD patients but has limited use for COPD?

<p>Albuterol (B)</p> Signup and view all the answers

Which short-acting beta2-agonist provides effective relief of symptoms and prevention of exercise-induced bronchospasm?

<p>Salbutamol (C)</p> Signup and view all the answers

Which bronchodilator resulted in similar improvements in lung function and health status compared to albuterol in a study comparing the two medications?

<p>Ipratropium bromide (A)</p> Signup and view all the answers

What is the most commonly used SABA in the USA?

<p>Albuterol (A)</p> Signup and view all the answers

Which SABA shows the most potent effect on peripheral muscles due to its non-selectivity for beta receptors?

<p>Isoprenaline (B)</p> Signup and view all the answers

What effect do SABAs have on lung function decline?

<p>No effect on lung function decline (A)</p> Signup and view all the answers

Which LABA showed significant bronchoprotective properties against challenges like methacholine and adenosine monophosphate?

<p>Formoterol (B)</p> Signup and view all the answers

What is considered the minimal clinically important difference in FEV1 required to relieve symptoms and escalate to recovery?

<p>15% (D)</p> Signup and view all the answers

Which anticholinergic agent has demonstrated superiority over ipratropium in improving lung function and health-related quality of life?

<p>Tiotropium (D)</p> Signup and view all the answers

What was found to be associated with an increased risk of adverse cardiovascular events in a recent systematic review and meta-analysis?

<p>Tiotropium (A)</p> Signup and view all the answers

Which type of adverse effects are typically dose-dependent and mild for all SABAs?

<p>Systemic effects (D)</p> Signup and view all the answers

What have studies shown regarding the benefits of LABAs used in patients with stable COPD compared to a placebo?

<p>Significant decrease in exacerbations requiring steroids only (B)</p> Signup and view all the answers

Which respiratory challenge showed significant bronchoprotective properties with arformoterol?

<p>Adenosine monophosphate (D)</p> Signup and view all the answers

Why did the FDA approve the use of tiotropium and salmeterol in combination for COPD patients?

<p>To focus on a trial of dual bronchodilator therapy as a stepping up strategy (B)</p> Signup and view all the answers

Why is combination therapy less well defined in COPD compared to asthma?

<p>Due to the bronchodilator effect being less in COPD patients compared to asthmatics (A)</p> Signup and view all the answers

What was the rationale behind including a trial of dual bronchodilator therapy in the GOLD guidelines?

<p>To provide a combination therapy option for patients with co-existing asthma and COPD (B)</p> Signup and view all the answers

Why was there a previous assumption that only anticholinergics should be used in COPD management?

<p>Because anticholinergics were believed to be more suitable for severe stages of COPD (C)</p> Signup and view all the answers

Why might the anti-inflammatory effects of corticosteroids in combination inhalers confound the interpretation of bronchodilator monotherapy in COPD?

<p>Because corticosteroids can mask the bronchodilator effects of monotherapy (C)</p> Signup and view all the answers

What makes combination therapy relevant for some COPD patients?

<p>The ability to achieve synergistic effects by targeting multiple pathophysiologic mechanisms (A)</p> Signup and view all the answers

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