COPD Flashcards
What is step 1 of COPD treatment?
SABA and SAMA
What is step 2 if patients have non-asthmatic features?
SABA
LAMA (discontinue SAMA)
LABA
What is step 2 if the patient has asthmatic feastures?
SABA
LABA
ICS
Discontinue SAMA
When should patients go to step 3?
If the patient has a severe exacerbation or more than 2 moderate exacerbations a year
What is step 3 treatment?
SABA
LAMA
LABA
ICS
What should you do if the patient doesn’t have asthatic features and is still not controlled on step 3?
Revert back to LAMA and LAMA and SABA
What should you do if patients with asthmatic features are still uncontrolled after step 3?
Theophylline
Oxygen therapy
Mucolytics
What should you offer all COPD patients?
Pneumococcal and influenza vaccines
What can be given as a prophylactic treatment during the winter?
Azithromycin 3x a week
When should you give a patient a rescue pack?
If they have had exacerbations in the last year
What is in a rescue pack?
Oral corticosteroid and antibiotic
Amoxicillin
Doxycyline
Clarithromycin
When should you avoid Clarithromycin in patients?
If they are already on prophylactic azithromycin
What is the drug treatment for a COPD exacerbation?
SABA/SAMA
Short course of prednisolone
Aminophylline if inadequate response to nebulised bronchodilators
Oxygen if needed to keep oxygen saturation within range
Why can you not give a SAMA or LAMA together?
Level of muscarinic side effects will be too much for the patient
