COPD TREATMENT SUMMARY - MEMORIZE THIS FOR SURE

Question 1

How is Dyspnea progressively treated?

Answer 1

For patients with persistent breathlessness or exercise despite being on bronchodilator monotherapy, the use of two long-acting bronchodilators is recommended.37
If the addition of a second long-acting bronchodilator does not improve symptoms, considering switching inhaler device or to a different molecule

Question 2

How are COPD exacerbations treated if:
1. Patient on LABA or LAMA and eosinophils <300
2. Patient on LABA or LAma and Eosinophils >300
3. Patient on LABA+LAMA and eosinophils >100
4. Patient on LABA+LAMA and Eosinophils <100
5. Patient on LABA+LAMA+ICS and experiencing pneumonia or sideffects
6. Patient on LABA+LAMA+ICS and needs further escalation

Answer 2

For patients with persistent exacerbations on bronchodilator monotherapy, escalation to a LABA+LAMA.
Further exacerbations while on LABA+LAMA therapy escalate to LABA+LAMA+ICS.
ICS may work better if blood eosinophil counts ≥ 100 cells/μL, with amn increased effect the higher the eosinophils.38