COPD Flashcards

1
Q

risk factors for COPD

A
  • smoking (85-90% of COPDers)
  • inhaled chemicals
  • alpha 1 antitrypsin deficiency
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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
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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
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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

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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
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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
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7
Q

COPD management depends on…

A
  • PEF % predicted
  • exacerbations
  • exacerbations requiring hospitalization
  • function: physical activity, energy levels
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