COPD treatment

Question 1

what cells cause the the inflammation in COPD?

Answer 1

neutrophilic inflammation

Question 2

what are the values for FVC, FEV1 and the ratio between them?

Answer 2

FVC - reduced
FEV1 - reduced
FEV1% - reduced

Question 3

how do you stage the severity of COPD?

Answer 3

stage 1 - FEV1% -

Question 4

general treatment of COPD?

Answer 4

stop smoking
increase exercise
treat poor nutrition/obesity

possibly - short acting antimuscarinic (ipratropium) or beta-2-agonist

Question 5

how to treat mild/ moderate COPD (stage 1/2)

Answer 5

inhaled long-acting muscarinic (tiotropium) or beta-2-agonist

Question 6

treatment of severe COPD?

stage 3

Answer 6

combination of long-acting beta-2-agonist + corticosteroids e.g. tiotropium

Question 7

treatment if very severe COPD?

stage 4

Answer 7

tiotropium + inhaled steroid + LABA

refer to specialist and consider steroid trial, home nebulisers and theophylline

Question 8

acute management of COPD?

Answer 8

iSOAP

i - ipratropium 
S - salmeterol nebulised 
O - oxygen 
A - amoxicillin 
P - prednisolone orally

Question 9

function of anti-muscarinics?

Answer 9

they are muscarinic acetylcholine antagonists of bronchoconstriction cause by smooth muscle M3 receptors in response to ACH released from parasympathetic nerve fibres

Question 10

what is the difference between ipratropium ad tiotropium?

Answer 10

ipratropium is a non-selective blocker of M1, M2 and M3

tiotropium is a more effective agent as it is specific to M3 receptors only