Management of COPD Flashcards

1
Q

Multi system disease

A

not only affects the lungs and breathing :
- muscle wasting and weight loss
- pulmonary hypertension
- anxiety and depression
- obstructive sleep apnoea
- acute respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of COPD

A
  • smoking
  • air pollution and dust
  • host factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who is a typical COPD patient ?

A
  • aged over 35
  • smoker
  • presentation with cough or excessive sputum production
  • frequent winter bronchitis
  • not presenting with typical clinical features of asthma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diagnosis

A
  • history of symptoms
  • cough
  • sputum production
  • dyspnoea
  • history of exposure to risk factors
  • objective evidence of obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Investigations

A
  • lung function tests
  • peak expiratory flow
  • arterial blood gases
  • chest x ray
  • sputum sample
  • reversibility testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment goals

A
  • smoking cessation
  • vaccinations
  • pharmacological therapy
  • oxygenation and ventilatory support
  • pulmonary rehabilitation
  • end of life support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Abbreviations

A

LABA = LONG ACTING BETA 2 AGONIST

LAMA = LONG ACTING MUSACRINIC ANTAGONSITS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Benefits of combining LABA AND LAMA

A
  • improved bronchodilation with minimal increase in the incidence of side effects
  • improve symptoms and lung function
  • greater impact on PROs
  • reduces exacerbations
  • most cost effective option
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Inhaled steroids in COPD

A
  • do not affect the rate of decline in FEV1
  • beneficial effect on exacerbation rate in severe disease
  • evidence to suggest the rate of decline in health status reduces
  • suggestion ICS improve long term survival
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Oral medications

A

Oral steroids ( eg. prednisolone ) = not usually recommended, advanced COPD when steroids cannot be fully withdrawn following exacerbation

Roflumilast - phosphodiesterase inhibitor - oral bronchodilator for severe COPD with chronic bronchitis

Mucolytics (EG. carbocisteine) = chronic cough, productive sputum

METHYLXANTHINES (EG. THEOPHYLINE ) - offered once inhaled therapy is optimise, add on therapy for breathlessness, drug interactions

Macrolide antibiotics ( azithromycin ) - specialist use only, reduce frequency of exacerbations, resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antibiotics

A

common pathogens :
- streptococcus pneumonia
- haemophilus influenza
- Moraxella catarrhalis

AMOXICILLIN 500 MG TDS
CO-AMOXICLAV 635MG TDS

DOXYCYCLINE OR CLARITHROMYCIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

STEROIDS

A

PREDNISOLONE 30MG OM FOR 5 DAYS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly