COPD & Asthma Flashcards
COPD Definition
-Defined by persistent respiratory symptoms due to limitation in the airflow in the airway and/or alveolar abnormalities.
-2 most common types: Chronic Bronchitis and Emphysema
COPD-Spectrum of Disease
-Large airway condition: chronic bronchitis, tracheomalacia, asthma, cystic fibrosis, bronchiectasis
-Small airway disease: bronchiolitis, bronchiolectasis
-Distal airspace disease: emphysema
Signs/Symptoms COPD
-Dyspnea, cough (chronic) +/- sputum production
-Recurrent respiratory infections
-Signs of malnutrition (BMI<19) or obesity
-Edema or cyanosis in the extremities
-Nasal polyps, cobblestoning in the airway, stridor, dysphonia
-Lung crackles, wheezing, expiratory slowing, decreased breath sounds
Initial COPD workup
-PFTs with bronchodilators
-Hyperinflated lungs, diaphragm may appear lower and flat on imaging
-Lung cancer screening
-CBC, BMP, Fasting glucose, NT-ProBNP
Alpha-1Antitrypsin Deficiency
-Most common cause of emphysema
Spirometry: FVC
-Measures the volume of air that can forcibly be exhaled from the point of maximal inspiration (forced vital capacity, FVC)
Spirometry: FEV1
Measures the volume of air exhaled during the first second of FVC (forced expiratory volume in one second, FEV1)
FEV1/FVC Ratio
The presence of an FEV1/FVC ratio of < 0.70 postbronchodilator confirms there is airflow limitation
GOLD Stage 1 (mild)
-FEV1/FVC <70%
-Can be managed w/ SABA, hospitalization not required
GOLD Stage 2 (moderate)
–FEV1/FVC <70%,
-FEV1 <50-70%
-Requires SABA, antibiotics and/or oral corticosteroids, hospitalization likely
GOLD Stage III (severe)
-FEV1/FVC <70%
-FEV1 <30-50%
-Evidence of acute respiratory failure
GOLD Stage IV (very severe)
-FEV1/FVC <70%
-FEV1 <30% or <insufficiency
Short Acting Beta2-Agonist (SABA) Bronchodilator -Albuterol containing
-Rescue Inhaler
-ProAIR
-Proventil
-Ventolin
-Xopenex
Long Acting Beta2-Agonist (LABA) Bronchodilator
(offers relief of coughing, wheezing, dyspnea for at least 12 hours)
Servant diskus
Striverdi Respimat
Inhaled Corticosteroids
reduce and prevent swelling of airways, does not provide relief for acute symptoms such as coughing, dyspnea, wheezing
-Flovent, Pulmicort
Arnuity Ellipta, Alvesco
Armon Air, Asmanex
QVAR