COPD Flashcards
What is COPD?
Chronic Obstructive Pulmonary Disease
Irreversible airway obstruction
What do you give for COPD for breathlessness or exercise limitation?
SABA or SAMA
Stop LAMA if started
What do you give for an exacerbation or persistent breathlessness in COPD?
FEV > 50% - LABA (then LABA/ICS) or LAMA
FEV < 50% - LABA/ICS or LAMA
What is triple therapy for persistent exacerbation or breathlessness in COPD?
LABA/ICS + LAMA
What do you give if symptoms persist or unable to use inhaler in COPD?
MR theophylline/aminophylline
What do you give for a chronic productive cough in COPD?
Mucolytic
What do you give if there is hypoxaemia in COPD?
Oxygen therapy
88-92% saturation
What is the mechanism of action of inhaled antimuscarinics?
Relaxes smooth muscle of bronchi to cause bronchodilation
What are the LABAs?
Long acting B2 agonist
Olodaterol (strivedi respimat)
Indaceterol (onbrez breezhaler)
Vilanterol with umeclidinium (anoro ellipta)
What are the SAMAs?
Ipratropium bromide (TDS)
What are the LAMAs?
Take once daily except Eklira (BD)
Aclidinium - eklira genuair
Glycopyrronium - seebri breezhaler
Umeclidinium- incruse ellipta
Tiotropium- spiriva handihaler
What are the cautions for antimuscarinics?
Prostatic hyperplasia
Risk of angle-closure glaucoma with nebulised ipratropium especially with salbutamol - protect eyes
What are the side effects of antimuscarinics?
Dry mouth
Paradoxical bronchospasm
What do you give for acute COPD exacerbations?
Bronchodilator therapy
IV aminophylline
Short course oral prednisolone - 30mg daily for 7-14 days
Antibacterial therapy - amoxicillin, tetracycline or clarithromycin
