3. COPD Flashcards

1
Q

What’s the cause of

COPD

A

Smoking

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2
Q

COPD

which vaccine do they needy yearly

A

Influenza

Pneumococcal vaccine

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3
Q

emphysema

Symptoms

A

Frequent coughing or wheezing.
A cough that produces a lot mucus.
Shortness of breath, especially with physical activity.
A whistling or squeaky sound when you breathe.
Tightness in your chest.

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4
Q

What is

Emphysema

A

Emphysema

is a lung condition that causes breathing difficulties. This and chronic (or long-term) bronchitis are the two main components of COPD. If you have emphysema, the walls of the air sacs in your lungs are damaged

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5
Q

COPD

What is it?

A

Chronic obstructive pulmonary disease, or COPD, describes a group of lung conditions that make it difficult to empty air out of the lungs because the airways have become narrowed.

Emphysema + chronic bronchitis = COPD

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6
Q

COPD

symptoms

A

Frequent coughing or wheezing all day

Excess phlegm or sputum.

Shortness of breath.

Trouble taking a deep breath.

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7
Q

Differentiate between

asthma & COPD

ICS

A

In asthma ICS help
3-4 weeks

ICS don’t help with COPD

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8
Q

Is COPD

Reversible?

A

No.

Irreversible air way obstruction

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9
Q

Asthma

Reversible?

A

Yes;

Reversible airway obstruction

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10
Q

COPD TX

If no asthmatic features
Productive cough, night + day

A

Step 1️⃣ is for ALL COPD

1️⃣ SABA/ SAMA prn

2️⃣non asthmatic features
LAMA+ LABA

if 1 severe or 2 moderate exacerbations
ADD: ICS

If Dady to day symptoms affect quality of life:
ADD: ICS for 3 months
(If no improvement remove ICS, refer SPECIALIST)

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11
Q

COPD TX

If asthmatic features

A

Step 1️⃣ is for ALL COPD

1️⃣ SABA/ SAMA prn

2️⃣asthmatic features
LABA + ICS

if 1 severe or 2 moderate exacerbations

OR

If Day to day symptoms affect quality of life:
ADD: LAMA

( NO improvement ? —> refer SPECIALIST)

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12
Q

The GOLD
COPD guidelines

FORCED EXPIRATORY VOLUME IN 1 second

FEV1 >50%

FEV1 <50%

A

= or more than 50%

Use LABA / LAMA

Less than 50%

Add ICS

Still no improvement

Triple therapy

LAMA + LABA + ICS

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13
Q

Target oxygen level in COPD

A

88-92%

Careful of hypercapnic respiratory failure (if history, carry a O2 alert card)

(High O2 will cause CO2 retention)

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14
Q

When does a COPD patient carry a

O2 Altert Card

A

History of hypercapnic respiratory failure

HCP to use a 24% or a 28% Venturi mask (with 02 therapy)

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15
Q

Antimuscarinic bronchodilators

Such as

ipratropium

tiotropium,

aclidinium

glycopyrronium

Caution in:

A

Prostatic hyperplasia

At risk of angle closure glaucoma

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16
Q

LABA

in

COPD

List: 3

A

Olodaterol - striverdi respimat

Indacaterol - onbrez breezhaler

Vilanterol + umeclidinium - anora elipta (combo)

17
Q

SAMA

Short acting antimuscarinic

In

COPD

A

Ipratropium

18
Q

LAMA

in

COPD

List

A

Aclidinium - eklira genuair BD

Glycopyronnium - seebri breezhaler OD

Umeclidinium - incruse elipta OD

Tiotropium - spiriva handihaler OD

19
Q

When can tiotropium- spiriva respimat

Be used in asthma pts who are already taking a LABA + ICS

A

Pts who suffered 1 or more severe acute exacerbation in the past year

20
Q

Start inhaled therapy ONLY if:

3

A
  • the non pharmacological steps haven been offered.
  • inhaled therapy is needed to relieve breathlessness
  • pts are trained adequately on inhaler technique
21
Q

Non pharmacological first steps before
Medicine

COPD

A

Stop smoking

Take the influenza & pneumococcal vaccines

22
Q

Acute COPD

Tx

A
  1. SABA/ SAMA
    via nebuliser with O2

No improvement?

IV Aminophylline

23
Q

COPD

After Acute attack
SOB interferes with day to day life
General Tx

A

If SOB interferes with daily life

Oral Prednisolone 30mg 7-14 days

If purulent sputum / high fever/ swollen lymph nodes
Or other signs of infection : ABX amoxicillin/ clarithromycin