Acute COPD- Treatment Flashcards
Acute COPD exacerbation: goals of therapy
Prevent disease progression, relieve symptoms, improve exercise tolerance, improve overall health status, prevent and treat exacerbations and complications, reduce morbidity and mortality
Acute COPD exacerbation: nonpharm treatment
O2: goal is 88-92%
Ventilation: noninvasive mechanical ventilation, intubation and mechanical ventilation
Palliative care
Acute COPD exacerbation: pharm treatment (just the drugs)
Bronchodilators: albuterol, ipratropium
Corticosteroids: prednisone or other equivalent
ABX: Augmentin, Unasyn, azithromycin, doxycycline, cefepime, pip/tazo, levofloxacin, carbapenem
Acute COPD exacerbation: bronchodilator dosing
1 puff q1h x2-3 doses, then 2 puffs q2-4h
Acute COPD exacerbation: bronchodilators clinical pearls
SABA preferred first-line
ACh can be added if symptoms are persistent with an increased dose of SABA
Acute COPD exacerbation: prednisone dosing
40mg PO QD
Acute COPD exacerbation: prednisone duration of therapy
5 days
Acute COPD exacerbation: prednisone formulation
Use PO unless a patient can’t tolerate (N/V, severe dyspnea)
When to taper prednisone dose
If treatment >14 days
What does prednsione do to recovery time for acute COPD?
Shortens it, also improves FEV1 and oxygenation, decreases risk of relapse/treatment failure and length of hospitalization
Criteria to treat COPD exacerbation with ABX
Moderately ill with 3 cardinal signs: increased dyspnea, increased sputum volume, and sputum purulence
2 cardinal symptoms, with one being sputum purulence
Mechanical ventilation
How long to treat with ABX for in acute COPD exacerbation
5-7 days
Bacteria to treat with ABX in acute COPD
H. influenzae, S. pneumoniae, M. catarrhalis
Augmentin dosing for acute COPD
875mg PO BID
Unasyn dosing for acute COPD
3gm IV q6h (renally eliminated)
