COPD Management Flashcards
What is the goal SpO2 for COPD exacerbations?
88-92%
Does IM terbutaline work in COPD exacerbations?
No
What is the advantage of albuterol nebs vs MDI with spacers?
Nebs can give when patients are tachypneic
True or false: using albuterol and ipratropium (or another beta agonist/anticholinergic) have a synergistic effect
True
Why are IV steroids preferred over oral in cases of severe COPD exacerbations?
Poor splanchnic perfusion
What is the recommended amount of prednisone for acute COPD exacerbations?
40 mg PO QD x 7-10 days
Which COPD exacerbations should get abx? (2)
- If admitted
- Increased sputum
What are the four major bacteria that cause COPD exacerbations?
- Strep pneumo
- H. Flu
- M. Catarrhalis
- Pseudomonas
What are the risk factors for pseudomonas infection in COPD exacerbations? (3)
- Frequent hospitalizations
- Frequent abx
- End stage
What is the abx of choice for outpatient COPD exacerbation?
Doxycycline
What are the abx of choice for admitted COPD exacerbations?
- Levaquin
- antipseudomonal abx
What respiratory bacteria does cipro cover well and not well?
- Well = pseudomonas
- Not well = atypicals and strep pneumo
What is the dose of Mg and over how long for COPD exacerbations?
2g over 20 minutes
What is the role of methylxanthines in COPD exacerbations?
Not recommended due to small therapeutic index
What are the steps to take to prevent breath stacking? (4)
- Low minute volumes
- Increase expiratory time
- Increase inspiratory flow rate
- Ensure good sedation/paralysis
