COPD Flashcards
What is the NICE definition of COPD?
COPD is characterised baby airflow obstruction that is usually progressive and not fully reversible and does not change markedly over several months. Predominantly caused by smoking.
Give 4 causes of COPD.
Smoking
Alpha-1-antitrypsin
Occupational exposure
Pollution
Give 7 signs of COPD
Purse lip breathing Tachypneoa Accessory muscles Barrel chest Wheeze Cyanosis Oedema if corpulmonale
What are the NICE guidelines on staging of COPD?
FEV1 - 50-80% = mild
FEV1 - 30-49% = moderate
FEV1 - <30% = severe
What can be used to see the bullae?
HRCT
Give 5 side effects of B2 agonists.
Tachycardia (atrial B2 receptors) Tremor (skeletal B2 receptors) Anxiety Palpitations hypokalemia
Give some systemic complications of anticholinergics.
SVT Atrial fibrillation urinary difficulty Urinary retention Constipation
Name an anticholinergic used in COPD treatment.
Ipratropium
3 modes of action of methyl xanthine.
Bronchodilation
Increased respiratory drive
Anti-inflammatory effects
Give some adverse effects of steroids.
Think skin Bruising Osteoporosis Adrenal insufficiency Cataracts Diabetes Increased weight due increased fluid retention Mental disturbance GI symptoms Proximal myopathy
Acronym to remember drug management of COPD
BSAMM
What is pulmonary rehabilitation?
What psychological effect does it treat?
Supervised exercise
Nutritional advice
Disease education
Deconditioning
When is LTOT offered?
7.3<
8< - with cor pulonale
What are the steps that should be taken in acute exacerbation management in COPD.
Aim for Sats 88-92% (controlled oxygen therapy)
Bronchodilators - nebuliser
ABx - infective features
(CRP/ WCC and infective sputum)
IV aminophylline
Repeat ABG - no better - consider non-invoice ventilation or ITU referral for invasive ventilation
When should non-invasiveventilation be used?
Acute exacerbation with Type II resp failure and mild acidosis (7.25-7.35)
