COPD Flashcards
what is COPD
progessive and not fully reversible with persistent respiratory symptoms
what causes airflow limitation in COPD
due to a combination of obstructive bronchocitis and emphysema
COPD symptoms
- dsypnoea (SoB)
- wheeze
- chronic cough
- regular sputum production
COPD risk factors
MAJOR and others
- major = SMOKING
- pollution
- occupational exposures
- genetic factors
COPD drug tx step 1
SABA or SAMA
Non-asthmatic COPD tx step 2
LAMA + LABA
- stop SAMA
CONTINUE SABA
Non-asthmatic COPD tx step 3
- severe exacerbation or 2x moderate in 1yr = LAMA + LABA + ICS
- if no changes AFTER 2MT then revert back to LAMA + LABA
CONTINUE SABA
Asthmatic COPD tx step 2
LABA + ICS
- stop SAMA
CONTINUE SABA
Asthmatic COPD tx step 3
LAMA + LABA + ICS
- IF still no change add = theophylline, O2 therapy, mucolytic
- offer pneumococcal and influenza vaccine
CONTINUE SABA
what is given if pt has COPD exacerbation within last yr
rescue pack
what is included in rescue pack for COPD excerbation
oral corticosteroid and antibiotic
which corticosteroid and antibiotics is commonly given for rescue pack
- prednisolone
- amoxicillin
- doxycycline
- clarithromycin
when is clarithromycin avoided
if taking prophylatic azithromycin
both macrolides
non-drug tx of COPD exacerbation
positive expiratory pressure helps sputum clearance
COPD exacerbation drug tx
- SABA/SAMA (withhold LAMA if SAMA given)
- short course of prednisolone
- add aminophylline
- oxygen PRN
