COPD

Question 1

1st line Rx

Answer 1

SABA / SAMA

for patients who remain breathless or have exacerbations despite using short-acting bronchodilators the next step is determined by whether the patient has ‘asthmatic features/features suggesting steroid responsiveness’

Question 2

2nd stage if features suggesting asthma?

Answer 2

LABA + ICS

Question 3

2nd stage if no asthmatic features?

Answer 3

LABA + LAMA

Question 4

Cor pulmonale facts

Answer 4

Cor pulmonale
features include peripheral oedema, raised jugular venous pressure, systolic parasternal heave, loud P2
use a loop diuretic for oedema, consider long-term oxygen therapy
ACE-inhibitors, calcium channel blockers and alpha blockers are not recommended by NICE