3: COPD Management Flashcards

1
Q

How do you track disease progression and reassess severity?

A
  • MMRC breathlessness assessment
  • Spirometry (perform regularly)
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2
Q

What is the treatment for this stage?

Stage 4: Very Severe

A
  • Active reduction of risk factors
  • Flu vaccine
  • SABA
  • 1 or more LABAs
  • Pulmonary Rehab
  • ICS if repeated exacerbations
  • O2 therapy if chronic respiratory failure
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3
Q

Upon initial diagnosis, what is the nonpharm treatment plan?

A
  • Smoking cessation
  • Referral for pulmonary rehab
  • Regular exercise
  • Phsych eval for eating disorder, depression
  • Nutritional eval
  • Patient education on COPD and smoking cessation
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4
Q

Which comorbidity should especially be monitored?

A

Cardiovascular

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5
Q

What are the pharm options for COPD?

A
  • SABAs (sympathomimetics)
  • Anticholinergics
  • LABAs (alone or combined with anticholinergic)
  • ICS
  • Systemic steroids
  • Methylxanthines (Theophylline)
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6
Q

Which type of COPD patients benefit little from mucolytic agents like Mucinex?

A

Stable patients benefit very little. More benefit with proper hydration (6-8 8-ounce glasses of water).

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7
Q

After placing a patient on initial pharm therapy, when should f/u occur?

A

1 month

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8
Q

What is the flow rate Rx for O2?

A

Prescribed at a flow rate to produce 90% saturation.

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9
Q

What is the treatment for this stage?

Stage 2: Moderate

A
  • Active reduction of risk factors
  • Flu vaccine
  • SABA
  • 1 or more LABAs
  • Pulmonary Rehab
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10
Q

What is the treatment for this stage?

Stage 3: Severe

A
  • Active reduction of risk factors
  • Flu vaccine
  • SABA
  • 1 or more LABAs
  • Pulmonary Rehab
  • ICS if repeated exacerbations
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11
Q

T/F Cough suppressants benefit bronchitis patients over emphysema patients.

A

False. They should be avoided in all. Benefits of expectoration are more important, esp to prevent pneumonia.

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12
Q

T/F COPD patients should be vaccinated for flu and pneumonia.

A

True. Vaccinate for influenza (annually) and pneumococcal pneumonia (every 5 years).

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13
Q

When is O2 therapy recommended?

A
  • Cor pulmonale
  • Transient (unrelated to exercise) or nocturnal desaturation
  • Need for exertion-induced dyspnea prophylaxis
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14
Q

What type of meals are beneficial?

A
  • Small, frequent meals
  • Nutritional supplements often beneficial in emphysema
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15
Q

Is postural drainage beneficial for bronchitis or emphysema?

A

Bronchitis

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16
Q

How often should the SABA and LABA be used?

A
  • SABA = PRN
  • LABA = BID
17
Q

What are the nonpharm options for COPD?

A
  • Pulmonary Rehab
  • O2 Therapy
  • Surgery
    • Bullectomy
    • Lung Volume Reduction (severe cases)
    • Lung Transplant (end-stage)
18
Q

What are the goals of COPD treatment?

A
  • Reduce symptoms and improve quality of life
  • Increase exercise tolerance/maximize lung function
  • Decrease exacerbations
  • Prevent disease progression
    • Smoking cessation
    • Precipitant avoidance
    • Infection prevention
19
Q

What is the treatment for this stage?

Stage 1: Mild

A
  • Active reduction of risk factors
  • Flu vaccine
  • SABA