COPD Flashcards
what is COPD
It’s an umbrella term for a common obstructive productive progressive disorder characterised by airway obstruction with little or no reversibility.
CHRONIC BRPONCHITIS- inflammation of bronchi and bronchioles.
EMPHYSEMA- distention and damage to alveoli (loss of elastic recoil), due to protease imbalance
what causes COPD
smoking, working in mines
symptoms of COPD
wheeze, productive cough, sputum, progressive dyspnoea
complications of COPD
acute exacerbations, polycythaemia, respiratory failure (often type 2), pneumothorax, lung carcinoma, hypertension
signs of COPD
tachypnoea, use of accessory muscles in respiration, hyperinflation, decre3ased cristernaldistance (<3cm), decrease expansion, hyper resonant percussion note, quiet breath sounds, wheeze, cyanosis, cor pulmonate (right ventricle enlarged)
What does a CXR look like for COPD
Hyperinflation, flat hemi-diaphragms, bullae
What does a CT scan look like for someone with COPD
bronchial wall thickening, scarring, air space enlargement
whats the treatment for acute COPD
- Ipratropium (SAMA)-nebulised
- Salbutamol (SABA)- nebulised
- Oxygen 24-28%, keep SaO2 between 88-92%
- Amoxycillin (if infection likely)
- Prednisolone- oral/ Hydrocortisone IV
- aminophyline- IV (if no response)
- Non invasive ventilation and respiratory stimulant- doxapram IV
- Consider intubated assisted ventilation if pH<7.36
Chronic treatment for COPD
- LABA/LAMA + SABA
2. LABA/LAMA/ICS- for frequent exerbator with high eosinophilic counts (>300 cells)
what is the gas exchange like for COPD patients
its impaired
when to give oral amoxicillin?
only during an exacerbation that there’s purulent sputum
oxygen target for COPD exacerbation with CO2 retention?
88-92%
oxygen target for COPD exacerbation with restored CO2?
94-98%
how to treat critically ill patients?
high flow oxygen immediately
