COPD: GOLD Flashcards
GOLD
Global initiative for
Obstructive Lung Disease
Measurements involved in GOLD
- FEV1/FVC
- mMRC
- CAT
- eCOPD
What FEV1/FVC indicates COPD
70%
How is the MRC dyspnoea scale scored?
0 = Not troubled by breathlessness except on strenuous exercise
1 = Short of breath when hurrying or walking up a slight hill
2 = Walks slower than other people of similar age on level ground because of
breathlessness, or has to stop for breath when walking at their own pace
3 = Stops for breath after
about 100m or after a few minutes of walking on level ground
4 = Too breathless to leave the
house, or breathless when dressing or undressing
What is given to all groups of patients for immediate relief of symptoms?
- Short-acting bronchodilators
e. g. SABA
Group A
- 0-1 moderate exacerbations (not requiring admission to hospital)
- MRC = 0-1
- CAT < 10
Group A - treatment
- A single long-acting bronchodilator
- Either LABA OR LAMA
- Long-acting is more preferred unless patients have occasional breathlessness
Group B
- 0-1 moderate exacerbations (not requiring admission to hospital)
- MRC = 2 or more
- CAT = 10 or more
Group B: treatment
- LABA + LAMA
- Ideally as one combined inhaler, rather than separate
Group E
- 2 or more moderate exacerbations (not requiring admission to hospital)
OR - ONE severe exacerbation requiring hospital admission
- MRC = 2 or more
- CAT = 10 or more
Group E: treatment
- LABA + LAMA
- However, if the blood eosinophil count is 300 or more, give LABA + LAMA + ICS (Triple therapy)
- Ideally given as a single combined product inhaler