COPD

Question 1

if a person has tiotropium on their prescription, what must you check for ?

Answer 1

if they’ve had their flu vaccine
+ pneumococcal vaccine
check if person is smoking (COPD is not reversible - stopping smoking can help patient) so give them smoking cessation advice

Question 2

What else must a person on COPD be on? How would this benefit the patient? What would be the procedures if there is no benefit?

Answer 2

A mucolytic - this will help with the patients chronic productive cough and reduce sputum viscosity
if theres no benefit after 4 weeks - they must be taken off the mucolytic (ex. carbocysteine)

Question 3

How is tx determined for a patient that has COPD?

Answer 3

this depends on the pts FEV1

Pt will be started on SABA or SAMA (short-acting muscarinic antagonist ex ipatropium)

Question 4

What is FEV1?

Answer 4

Forced expiratory volume
Its the amount you can exhale in 1 second
This will be above 50% or below 50%

Question 5

If pts FEV1 is above 50%, what tx will they recieve?

Answer 5

1. if FEV1 is above 50%, give LABA or LAMA (long acting muscarinic antagonist)
   If on LAMA, discontinue SAMA.

If pt is on LABA and still experiencing persistent exacerbations or breathlessness, give inhaled corticosteriod.

2. If pt is on LAMA and still experiencing ^^ - pt must be put on LABA, LAMA and ICS

if pt is on LABA and ICS - a LAMA must be added

Question 6

if pts FEV1 is below 50%, what tx will they receive?

Answer 6

1. SABA or SAMA
2. if below FEV1 50% - LABA + ICS OR LAMA (x SAMA)
3. if this isnt helping they would be given:
   - LAMA, LABA and ICS