COPD (obstructive and restrictive disease) Flashcards
What is COPD?
COPD is airflow obstruction. It is progressive in severity, not fully reversible, it doesn’t change rapidly over several months. It is an umbrella term for chronic bronchitis, emphysema and chronic asthma.
How does normal airway clearance occur?
Normally our airways are lined with cells that produce mucus, this traps any dust or bacteria particles. Tiny hairs called cilia then beat to clear the mucus out of out lungs where it will be coughed up or swallowed.
What can go wrong with airway clearance in the people COPD?
Thick, sticky excess mucus is produced, this traps the cillia and prevents them from moving. A lot of patients will be smokers who have paralysis of the cillia which traps the dust and bacteria creating a warm moist environment for bacteria to grow, causing re-occurring chest infections.
What is bronchitis?
It’s a chronic disease where the bronchi become inflamed, inflammation causes increased mucus, which narrows the airways creating breathing problems. The mucus is so thick patients struggle to clear there chest.
Wheezing is common, chronic cough.
What is emphysema?
Alveoli become inflamed and lose their natural elasticity. Alveoli become ruptured and surface area of alveoli therefor decreases making diffusion harder. Air gets trapped in the alveolar sacs and can not breathed out easily making it increasingly difficult to breath.
What is asthma?
Common disease where obstruction of the airways occur due to episodic stimuli, eg. Allergy, dust, pollen. Causing increased airway resistance. asthma Is reversible. Symptoms include: breathlessness, wheeze, tightness in chest.
If asthma is not managed chronic scaring of the airways can occur causing permanent damage of the airways.
What are the causes of COPD?
Cigarette smoking 20 pack years.
Occupational exposure-coal, chemical breathing,
Genetic link due to deficiency if alpha-1 antitrypsin.
How are patients diagnosed?
Detailed patients history.
Clinical signs of breathlessness on exertion, cough increased sputum.
Spirometers is used to diagnose, categories severity, and monitor progression.
Chest x-rays.
How do we classify patients with COPD give each stage?
3 stages early,moderate,severe.
Early= few symptoms, morning cough, breathlessness doesn’t limit activity, chest infections in winter. Clinical examination may appear normal.
Moderate=have increased cough, wheeze, SOB with moderate exertion, clinical examination may show hyper inflation, barrel chest, flattened diaphragm,
Severe= centrally cyanosed, weight loss, peripheral oedema,
What treatment can be given to COPD patients?
Stop smoking,
Nicotine Replacement,
Refer patients to smoking help/ smoking cessation,
Medications eg inhalers, steroids and antibiotics, mucolytics, flu and pneumonia vaccines.
Pulmonary rehabilitation- exercise, education, self management, diet, lifestyle modifications
What are bronchodilators?
Decrease spasm by relaxing the smooth muscle and empty the lungs of trapped air.
Used to reduce inflammation.
How would you use an aerosol inhaler compared to a dry powder inhaler?
Aerosol inhalers should be used with a slow and steady breath.
Dry powder inhalers should be used with a quick and deep breath.
What are the stages when using an inhale device?
Prepare device, Load the dose, Breathe out, Make a a seal around the mount piece, Use correct breathing technique (slow or fast) Remove inhaler and hold for 1 second Repeat as directed.
What’s are the 2 types of bronchodilators?
Short acting and long acting.
Name a shot acting bronchodilator and give some possible side effects?
Salbutamol,
Shaky and cramping hands,
Racing heart/ palpations,
Flushing,
Headaches
