Emphysema Case Study

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Irving Olson, a 75 year old non-Hispanic, Caucasian male was diagnosed with emphysema in November 2015.  He is currently taking salmeterol/fluticasone 100/50 one inhalation twice daily.  He is here today for routine follow up regarding emphysema.

Questions:

  1. What are the treatment goals for a patient with emphysema?
  2. What are non-pharmacologic treatment strategies for the management of emphysema?
  3. Is Irving’s current pharmacologic management consistent with current clinical practice guidelines? Discuss at least 2-3 pharmacologic options for the treatment of emphysema (be sure to include, at a minimum, drug name, dose, route, frequency)? What COPD stage would you use these medications?
  4. What is the mechanism of action of ONE of the pharmacologic agents discussed in #3? How does the mechanism of action correlate with the physiology/pathophysiology of emphysema?
  5. What are the most common adverse effects of ONE of the pharmacologic agents discussed in #3?
  6. What is the cost of ONE of the pharmacologic agents discussed in #3?
  7. Discuss pharmacokinetics and pharmacodynamics of ONE of the pharmacologic agents discussed in #3?(be sure to include, at a minimum, onset, peak, duration, half-life, etc).