COPD Flashcards
1
Q
risk factors for COPD
A
- smoking (85-90% of COPDers)
- inhaled chemicals
- alpha 1 antitrypsin deficiency
2
Q
diagnosing COPD
A
- spirometry: post bronchodilator FEV1/FVC <0.7
- consider CXR to exclude other diagnoses
- alpha1 antitrypsin serum level if age <65 or <20 pack year history
3
Q
acute exacerbation of COPD definition and causes
A
- > 48 hours worsening of dyspnea, cough, sputum volume or purulence
- causes: infection (50%), CHF, PE, MI, anemia, irritants
4
Q
acute exacerbation of COPD management
A
- SABA (Ventolin) + LAMA (spiriva)
- mod to severe: Add 30-50mg pred daily × 5d
- consider antibiotics for increased purulence:
- simple (no risk factors): amox OR doxy OR septra OR azithro OR tetracycline
– complicated : amox-clav OR levo OR moxiflox
**risk factors for complicated AECOPD: FEV1< 50% predicted, 4 or more exacerbations / year, cardiac disease
5
Q
non-pharm COPD management
A
- smoking cessation
- exercise
- written action plan
- review puffer technique and patient education
- pulmonary rehab
- vaccines: annual flu, pneumococcal
6
Q
pharm COPD management
A
- mild : SAMA prn OR SABA prn OR combination SABA + SAMA
- moderate : LAMA and SABA prn OR LABA and SABA prn
- severe : LAMA and LABA and SABA prn
- severe : LAMA and LABA and ICS and SABA prn
7
Q
COPD management depends on…
A
- PEF % predicted
- exacerbations
- exacerbations requiring hospitalization
- function: physical activity, energy levels