COPD Flashcards
COPS most common symp
Main-
Dyspnea
Cough
Sputum
and also- Wheezing Chest tightness Fatigue Weight loss Syncope
What is required to make COPD diagnosis
Spirometry
Spirometry values to determine COPD
FEV1/FVC < 0.7
Confirms persistant airflow limitation
Key indicators for considering COPD diagnosis
Dyspnea that progresses in time Chronic cough Chronic sputum Recurrent LRTI Risk factors (smoking...) Family history of COPD
DD of COPD
Asthma Lung cancer TB Bronchiectasis LHF CF
Which one goes down in COPD patients?
FEV1
FVC
Both, But FEV1 goes even lower
GOLD1
Mild
FEV1 > 80% Predicted
GOLD2
Moderate
FEV1 50-80% Predicted
GOLD3
Severe
FEV1 30-50% Predicted
GOLD4
Very severe
FEV1 < 30% Predicted
COPD exacerbation classified as
Mild
Moderate
Severe
How do we treat Mild COPD exacerbation?
Slow Acting Broncho-Dilators
How do we treat Moderate COPD exacerbation?
SABD
Oral AB
Oral corticosteroids
How do we treat Severe COPD exacerbation?
Hospetalization
Prevention and Maintenance therapy
Smoking cessation Influenza vaccination Pneumococcal vaccine Rehabilitatio Oxygen therapy
Which adrenergic R are prsent in the lungs
B-2
Example for short acting B2-agonists
Salbutamol (Albuterol)
Fenoterol
Example for long acting B2-agonists
Formoterol
Salmeterol
Muscarinic antagonists long acting examples
Tiotropium
Aclidinium bromide
Muscarinic antagonists short acting examples
Ipratropium
Oxitropium
Goals for treatment of stabe COPD
Reduce symp.
Reduce risk
Describe the management cycle
Review
Assess
Adjust
Stable COPD treatment choice-
We choose group A or B options when the patient-
Had 0-1 moderate exacerbations
Stable COPD treatment choice-
We choose group C or D options when the patient-
Had > 2 moderate exacerbation
or
1 leading to hospitalization
Group A is treated with
Bronchodilator
Group B is treated with
LABA
or
LAMA
Group C is treated with
LAMA
Group D is treated with
LAMA or LAMA+LABA or ICS+LABA
Most common cause for COPD exacerbation
Respiratory tract infections
COPD patients with acute respiratory failure should be given
Non-Invasive mechanical ventilation
2 Symptoms assessment tests:
CAT (COPD Asse. Test)
mMRC (modified Medical Research Council)
CAT test- What does it contain?
8 questions
Answers 0-5
Score 0-40
mMRC test- What does it contain?
Tick 1 box only that applies to you
Grade 0-4
What blood count can predict exacerbation rate?
Eosinophils count in patients treated with LABA without ICS
Group A and C when assesment test is
mMRC 0-1
CAT < 10
Group B and D when assesment test is
mMRC > 2
CAT > 10
Define what is COPD exacerbation-
Acute worsening of respiratory symptoms that results in additional therapy
How do you usually treat acute exacerbation?
SABA
with or without
SAMA