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</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</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</p> Signup and view all the answers

    What is the most commonly used SABA in the USA?

    <p>Albuterol</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</p> Signup and view all the answers

    What effect do SABAs have on lung function decline?

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

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

    <p>Formoterol</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%</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</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</p> Signup and view all the answers

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

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

    Which respiratory challenge showed significant bronchoprotective properties with arformoterol?

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

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