COPD Flashcards
chronic obstructive pulmonary disease
IRREVERSIBLE chronic airflow obstruction for which no cure exists
COPD is a combo of what 2 disease processes?
- chronic bronchitis
- emphysema
chronic bronchitis
excessive bronchial mucous production
how long do pts have to cough for to be diagnosed with chronic bronchitits?
pt has to have chronic cough for 3 consecutive months within the last two years
how many Americans have COPD?
24 million
T/F: COPD is the 3rd leading cause of death in US
true
etiology of COPD
- smoking
- genetic susceptibility
- long-term exposure to occupational and environmental pollutants
genetic susceptibility of COPD
production of inflammatory mediators in response to smoke exposure
what changes in large airways are seen in pts with chronic bronchitis?
- thickened bronchial walls
- enlargement of mucous glands
what changes in small airways are seen in pts with chronic bronchitis?
narrowing, scarring, increased sputum production, mucous plugging, collapse of peripheral airways
T/F: chronic bronchitis obstructs inspiration
false
obstruction on inspiration AND expiration
pathophysiology of emphysema
- smoke injures lung parenchyma
- air spaces enlarge and lose elastic recoil
how does smoke injure lung parenchyma?
- alveolar epithelium is damaged
- inflammatory cells migrate to damage site
- cells release enzymes that destroy alveolar walls
T/F: emphysema obstructs expiration
true
complications of COPD
- progressive deterioration with periodic exacerbations
- progressive dyspnea
- recurrent pulmonary infections
- pulmonary hypertension
- thoracic bullae & pneumothorax
pulmonary hypertension is a complication of COPD seen in pts with what?
right-sided heart failure
medical management
- smoking cessation
- annual influenza & pneumoccal vaccinations
- pharmacologic management
- supplemental O2
what drugs are COPD pts on?
- scheduled short & long-acting bronchodilators
- anticholinergics
- antibiotics prn
why are anticholinergics given to COPD pts?
decreases mucous production
*don’t prescribe, leave it to treating physician
what is given to refractory COPD pts?
inhaled steroids
*for pts who aren’t responding to short or long bronchodilators
for severe COPD cases, what is given?
Theophylline
should you provide dental care to COPD pts with SOB at rest, productive cough, upper resp infection?
no, reschedule elective txtment
dental mods for pts with stable COPD
- upright or semi-supine chair positioning
- bilateral IAN or palatal blocks can be uncomfortable
- nitrous oxide/oxygen for pts in mild-moderate COPD
should you give pts with severe COPD nitrous oxide?
no, nitrous can get trapped
heavy smoker is more on the chronic bronchitis or emphysema side?
emphysema
what drugs should pts with stable COPD avoid because it’ll dry out secretions?
anticholinergics or antihistamines
what drugs should pts with stable COPD avoid because it’ll further decrease respiratory drive?
narcotics like fentanyl
