Management guidelines

Question 1

COPD therapy according to severity of disease

Answer 1

Stage of COPD

• Treatment

At risk

• Avoidance of risk factors esp. smoking
• Influenza & pneumococcal vaccination
• Haemophilus influenzae vaccination

Mild

• Add short-acting bronchodilator (SABA)

Moderate

• Add long-acting bronchodilator (LABA + LAMA)
• Consider LABA/ICS and referral
• Add pulmonary rehabilitation

Severe

• Add inhaled corticosteroids (ICS)

Very severe

• Add long-term O2 (if chronic respiratory failure)
• Consider surgical referral (?lung reduction or transplantation)

Question 2

Stepwise approach to management of COPD

* Poor symptom control

Answer 2

Question 3

Management plan for acute exacerbation of COPD

Answer 3