COPD Flashcards
What is chronic bronchitis?
Chronic inflammation of the airways
Productive cough on most days for 3 months for 2 years
What is emphysema?
Alveoli are enlarged and damaged
reduces area for gas exchange
What are pink puffers?
Increased alveolar ventilation
Normal PaO2 Low PaCO2
Breathless but not cyanosed
Progress to type 1 respiratory failure
What are blue bloaters?
Decreased alveolar ventilation
Low PaO2 High PaCO2
Cyanosed but not breathless
Progress to cor pulmonae
Symptoms of COPD
Cough Sputum Dyspnoea Wheeze (Maybe) cyanosed
Signs of COPD
Tachypnoea Use of accessory muscles Hyperinflation Decreased chest expansion Hyperesonant on percussion Quiet breath sounds Wheeze cor pulmonae
Investigations for COPD
Peak flow (decreased)
Spirometer (low FEV, normal FVC, decreased FEV/FVC)
Trial of oral steroids
ABGa (hypoxia, hypercapnia)
General treatment of COPD
Smoking cessation Exercise Nutrition Pneumococcal vaccine Pulmonary rehab/ palliative care p.r.n. SAMA (ipratropium) or B2 agonist
Treatment of mild/moderate COPD
Inhaled LAMA (tiotropium) or LABA (salmetarol)
Treatment of severe COPD
Combination of LABA + corticosterd or tiotropium
Action if already on severe COPD treatment but still symptomatic
LABA + LAMA + corticosteroid
Refer to specialist
What is alpha 1 antitripsin?
A protease inhibitor produced in the liver
Secreted into the blood and diffuses into the lungs
What does aloha 1 antitripsin do?
Inhibits proteome tic enzymes in the lungs which are capable of destroying alveolar connective tissue
What does aloha 1 antitripsin deficiency predispose to?
Emphysema
Management of infective exacerbation of COPD
i - ipratropium S - salbutamol O - oxygen A - amoxicillin P - prednisolone
