COPD Flashcards
What is COPD and describe its pathology
Progressive narrowing of the airways thereby limiting airflow.
Increased secretion of mucus causing airways to become obstructed
The obstruction and the mucus increase resistance to airflow and favour bacterial colonisation in the retained mucus.
what are the risk factors of COPD
smoking (80%)
environmental pollution
Genetic factor
occupational exposure
Age > 35
Poor diet
Describe Emphysema in COPD pathophysiology
shortness of breath due to destruction of terminal bronchioles decreases area for exchange of gas
Difference between COPD and asthma
Smokers or ex smoker
COPD is mostly associated to smokers while in asthma it maybe a possible factor
Chronic productive cough
theres chronic productive cough in COPD patient while this is uncommon in asthma
Breathlessness
breathlessness is progressive and persistent in COPD patient but more variable in asthma
Night -time waking up
Asthma is more associated to night night waking up with breathlessness or wheezing while this is uncommon in COPD
Day -day variability of symptoms
common in asthma, uncommon in COPD
How is COPD diagnosed
Suspect a diagnosis of COPD in people
over 35 who have a risk factor (generally smoking or a history of smoking) and who present with 1 or more of the following symptoms:
breathlessness
chronic cough
regular sputum production
frequent winter ‘bronchitis’
wheeze.
confirm obstructive airway by performing Post-bronchodilator spirometry. (FEV1/FVC is < 0.7 and >_ 80% respectively indicates COPD
What is the AIM for the treatment of COPD
Prevent and control symptoms
Reduce the frequency and severity of exacerbations
Improve general health status
Improve exercise tolerance
State the primary symptom of COPD
Breathlessness
What are the Rehabilitation management for COPD
offer support for smoking cessation
offer pneumococcal and flu vaccination
offer O2 therapy
offer pulmonary rehabilation if indicated
Refer people who need assistance with ventilation to specialist center
Teach patient how to use Positive expiratory pressure devices to help with clearing sputum
When should you start inhaled therapies for COPD
When non-pharmacological management have failed
Discuss treatment routine for COPD
INHALED THERAPY
using SABA(e.g salbutamol) or SAMA (e.g ipratropium bromide) to relieve breathlessness and exercise limitation
INHALED COMBINATION THERAPY
No Asthma features (LABA +LAMA),
(formoterol or salmeterol + tiotropium bromide)
if they have day-day adverse symptoms use Inhaled triple therapy for 3 months. if does not work revert back to (LABA +LAMA)
Asthma symptoms (LABA + ICS)
INHALED TRIPLE THERAPY
(LABA + LAMA + ICS) if;
- Has day-day symptoms that adversely impact quality of life.
- 1 severe or 2 moderate exacerbation within a year
Why not ICS
To reduce use of ICS
ICS causes increased side effects such as Pneumonia
