COPD Flashcards
What are the symptoms of COPD?
- dyspnea
- cough
- sputum production
- wheezing
chronic, progressive symptoms not fully reversible
What genetic condition can predispose someone to COPD?
alpha-1 antitrypsin deficiency
What is required to assess lung function?
spirometry- amount of air a person can breathe out
What confirms a diagnosis of COPD?
post-bronchodialator FEV1/FVC <0.7
What are the key differences of COPD?
- common sputum production
- persistent symptoms
- progressive disease
- treatment with bronchodilators
What post-bronchodilator FEV1 is mild (GOLD 1)?
FEV1 ≥80%
What post-bronchodilator FEV1 is moderate (GOLD 2)?
FEV1 50-79%
What post-bronchodilator FEV1 is severe (GOLD 3)?
FEV1 30-49%
What post-bronchodilator FEV1 is very severe (GOLD 4)?
FEV1 <30%
How are COPD symptoms assessed?
- CAT (0-40)
- mMRC (0-4)
higher numbers are worse symptoms
What is a COPD exacerbation?
increase in respiratory symptoms that increase over <14 days
What is a combined assessment of COPD?
symptoms assessment (CAT and mMRC) and risk of exacerbations (A,B,E)
What is nonpharm treatment for COPD?
- smoking cessation
- pneumonia and flu vaccines
- inhaler technique
- long term oxygen treatment
What is first-line treatment for COPD?
Bronchodilators:
1. SAMA (short-acting muscarinic antagonist)
2. SABA (short-acting beta 2 agonist)
3. LAMA
4. LABA
When are ICS used in COPD?
- eosinophil count ≥300
- eosinophil count ≥ 100 and not controlled on LAMA+LABA
What is a group A COPD patient?
- CAT <10
- mMRC 0-1
- 0-1 moderate exacerbations (oral steroid± antibiotics) not requiring hospitalization
What is a group B COPD patient?
- CAT ≥10
- mMRC ≥2
- 0-1 moderate exacerbations (oral steroid± antibiotics) not requiring hospitalization
What is a group E COPD patient?
- ≥ 2 moderate exacerbations
- ≥1 exacerbation leading to hospitalization
What treatment should all patients have in addition to long-acting maintenance medications?
SABA and/or SAMA to relieve acute symptoms as needed
What are the preferred treatment for group A patients?
SAMA/SABA prn + LAMA/LABA
What are the preferred treatment for group B patients?
LAMA+LABA
What are the preferred treatment for group E patients?
LAMA+LABA
if eosinophils ≥300 consider LAMA+LABA+ICS
What agent is a SAMA?
Ipratropium (Atrovent HFA)