3: COPD Management Flashcards
How do you track disease progression and reassess severity?
- MMRC breathlessness assessment
- Spirometry (perform regularly)
What is the treatment for this stage?
Stage 4: Very Severe
- Active reduction of risk factors
- Flu vaccine
- SABA
- 1 or more LABAs
- Pulmonary Rehab
- ICS if repeated exacerbations
- O2 therapy if chronic respiratory failure
Upon initial diagnosis, what is the nonpharm treatment plan?
- Smoking cessation
- Referral for pulmonary rehab
- Regular exercise
- Phsych eval for eating disorder, depression
- Nutritional eval
- Patient education on COPD and smoking cessation
Which comorbidity should especially be monitored?
Cardiovascular
What are the pharm options for COPD?
- SABAs (sympathomimetics)
- Anticholinergics
- LABAs (alone or combined with anticholinergic)
- ICS
- Systemic steroids
- Methylxanthines (Theophylline)
Which type of COPD patients benefit little from mucolytic agents like Mucinex?
Stable patients benefit very little. More benefit with proper hydration (6-8 8-ounce glasses of water).
After placing a patient on initial pharm therapy, when should f/u occur?
1 month
What is the flow rate Rx for O2?
Prescribed at a flow rate to produce 90% saturation.
What is the treatment for this stage?
Stage 2: Moderate
- Active reduction of risk factors
- Flu vaccine
- SABA
- 1 or more LABAs
- Pulmonary Rehab
What is the treatment for this stage?
Stage 3: Severe
- Active reduction of risk factors
- Flu vaccine
- SABA
- 1 or more LABAs
- Pulmonary Rehab
- ICS if repeated exacerbations
T/F Cough suppressants benefit bronchitis patients over emphysema patients.
False. They should be avoided in all. Benefits of expectoration are more important, esp to prevent pneumonia.
T/F COPD patients should be vaccinated for flu and pneumonia.
True. Vaccinate for influenza (annually) and pneumococcal pneumonia (every 5 years).
When is O2 therapy recommended?
- Cor pulmonale
- Transient (unrelated to exercise) or nocturnal desaturation
- Need for exertion-induced dyspnea prophylaxis
What type of meals are beneficial?
- Small, frequent meals
- Nutritional supplements often beneficial in emphysema
Is postural drainage beneficial for bronchitis or emphysema?
Bronchitis