COPD GOLD Flashcards
What are GOLD guidelines used for
in COPD to come up with a treatment plan
How is it diagnosed
confirmed by spirometry
where post bronchodilator FEV1/FVC ratio of <0.7 indicates airflow limitation
what tools are used to assess impact of symptoms (2)
COPD Assessment Test (CAT) or the Modified Medical Research Council (mMRC) dyspnea scale
What is risk of exacerbations based on and state what is low risk and high risk
The risk of future exacerbations is based on the history of previous exacerbations:
Low risk: 0-1 exacerbations without hospitalization in the past year.
High risk: 2 or more exacerbations or any exacerbation requiring hospitalization in the past year.
What is the ABC-D classification based on
and what is each classification
Based on symptoms (CAT/mMRC scores) and exacerbation history, patients are categorized into Groups A to D:
A: low symptoms, low risk
B: high symptoms, low risk
C: low symptoms, high risk
D: high symptoms, high risk
What are the different treatments
Based on ABCD classification
Group A: Low symptoms, low risk.
- SABA or SAMA as needed
Group B: High symptoms, low risk.
- LABA or LABA regular basis to control symptoms
Group C: Low symptoms, high risk.
- LAMA preferred due to better exacerbation prevention
Group D: High symptoms, high risk.
- severe symptoms: LABA + LAMA
- alt ICS + LABA if history of frequent exacerbations and signs of eosinophilic exacerbation
For people still symptomatic on initial therapies based on their ABCD class, what can you do
combinations of LAMA + LABA + ICS are used.
These two drugs may be added in cases with frequent exacerbations despite maximum inhaled therapy, particularly in patients with chronic bronchitis.
Roflumilast or macrolide antibiotics (like azithromycin)
What is group e and what treament would you give to these pt
2 or more exacerbations, or one that resulted in hospitalisation
treatment: LABA + LAMA
Add ICS if eosinophils >300
what is group A and what treatment is given to these pt
MMRC <2 CAT score <10
Treatment = bronchodilator e.g. SAMA SABA etc
what is group B and what treatment is given to these pt
mmrc score >2, CAT score >10
treatment = LABA + LAMA
if FEV1/FVC ratio is this, then it indicated COPD
<0.7
what is MMRC score
measure of breathlessness
if 0-1 = group A or E
if <2 then group B
what is CAT score
COPD asssessment tool
<10 = A or E
> 10 = B or E
patient has MMRC (breathlessness score) of 0-1 and CAT (COPD assessment tool) of <10.
what group and what treatment
A
give bronchodilator
