COPD Flashcards
Sx of COPD
dyspnea, chronic cough, sputum production and wheezing
Most common cause of COPD
smoking
Emphysema definition
destruction of alveoli
Bronchitis definition
inflammation and narrowing of the bronchial tubes
What deficiency makes someone at a higher risk of developing COPD
alpha-1 antitrypsin (AAT) deficiency
Limitation of airflow is reversible in someone with COPD or asthma?
Asthma - NOT COPD
What is required to diagnose COPD
spirometry
What post-bronchodilator FEV1/FVC confirms diagnosis of COPD?
<0.70
COPD vs asthma
age of onset
COPD: >40
Asthma: <40
COPD vs asthma
Smoking hx
COPD: usually >10 years
Asthma: uncommon
COPD vs asthma
Sputum production
COPD: common
Asthma: infrequent
COPD vs asthma
Allergies
COPD: Uncommon
Asthma: Common
COPD vs asthma
Symptoms
COPD: Persistent
Asthma: Intermittent and variable
COPD vs asthma
Disease process
COPD: Progressive, worsens over time
Asthma: Stable, does not worsen over time
COPD vs asthma
Exacerbations
COPD: Common
Asthma: Common
COPD vs asthma
First-line treatment
COPD: Bronchodilators
Asthma: Inhaled corticosteroid
What are the four aspects of COPD assessment
Degree of airflow limitation
Symptoms
Risk of exacerbations
Presence of comorbidities
What are the FEV1 measurements in each GOLD category?
Gold 1 - mild - FEV1 >80%
Gold 2 - moderate - FEV1 50-80%
Gold 3 - severe - FEV1 30-50%
Gold 4 - very severe - FEV1 <30%
What is the mMRC and what does it test?
Dyspnea scale that assesses breathlessness
Higher score = worse
What exacerbation history, CAT score, and mmRC score puts patients in COPD groups A, B, C, and D
D: 2 exacerbations or 1 hospitalization, CAT 10 or more, mMRC 2 or more
C: 2 exacerbations or 1 hospitalization, CAT < 10, mMRC 0-1
B: 0-1 exacerbations, CAT 10 or more, mMRC 2 or more
A: 0-1 exacerbations, CAT < 10, mMRC 0-1
Non-pharm COPD therapy
Smoking cessation - only one to slow progression
Vaccines reduce hospitalizations (flu and pneumonia vaccine)
Do COPD medications modify long-term decline in lung function, reduce mortality, decrease sx, or prevent complications?
only decrease sx and prevent complications (exacerbations and hospitalizations)
Initial pharmacologic therapy for each COPD group A, B, C, and D
A: SABA or SAMA PRN, LABA or LAMA
B: LAMA or LABA
C: LAMA
D: LAMA or LAMA + LABA or LABA + ICS if eosinophils >300
When should you initiate antibiotics in someone with a COPD exacerbation?
Increased sputum purulence, sputum volume, dyspnea or if mechnaical ventilation is required
Utilize for 5-10 days
