COPD Flashcards
def. COPD
resp. disorder mainly caused by smoking, characterized by progressive and partially reversible airway obst. and lung hyperinflation, systemic manifestations, and increasing freq. and severity of exacerbations.
def. chronic bronchitis
excess mucous secretions in thebronchial tree on most days for at least 3 months of the year for at least 2 years
def. emphysema
lung condition char by abnormal, permanent, enlargement of the airspace distal to the terminal bronciole, acompanied by wall destruction without fibrosis
what is COPD epi
only major cause of death on the rise
F>M
6 steps to approach to COPD
- diagnosis
- preventative measures
- pharma
- non-pharma
- prevention of AECOPD
- surgical
**2 requirements for COPD diagnosis
- post dilator FEV1
3 major physio changes in COPD
- mucous hypersecretion
- ciliary dysfunciton
- airflow obstruction
4 Sx of COPD
- cough
- wheeze
- sputum
- dyspnea
what are 5 grades of COPD
- breathless with strenous excercise
- walks slower than others their age and stops for breath
4 - can’t leave house and breatheless when dressing
what is better approach to prognosos
functiontional grade
- better than FEV1
what is best thing can do for COPD
quit smoking
- earlier better
4 classes of meds for COPD
- inhaled bronchdilators
- oral bronchdilators
- anti-inflammatory
- oxy
4 types of inhaled dilators
- short acting antichol
- long acting antichol
- short acting beta-agon
- LABA
what is the problem with hyperinflation
increased residual volume leads to less VC
what is air trapping
- results in increased work of breathing
- places resp. muscles at a diadvantage
- contributes t feeling of dyspnea
how do anti-cholinergics (tiotropium) work
lowers the FRC
what is use for dilators
- for Sx only
- may help reduce hyperinflation
when to use inhaled steroids
NOT as a first line or monotherapy
- may delay decline in QOL
- decrease freq. of exacerbations
- can be added to LABA
what is use for PDEi’s
- non specific
- increase cAMP, bronchodilation
- anti-inflammatory
- blocks adenosine-r
benefits of pulmonary rehab
- reduced dyspnea
- increase exercise cap.
- inprove QOL
- reduced admissions
- less leg discomfort
what is use of oxygen therapy
must be used 24hrs a day to be useful for survival benefit
what is AECOPD def.
sustained worsening of dyspnea, cough or sputum excretion, leading to an increased use in meds
5 Tx of AECOPD
- optimize bronchodilation
- avoid resp. irritants
- O2 as needed
4 SYSTEMIC steroids - AB if purulent
see table
soso
