Management of COPD Flashcards
What are the aims of COPD management strategies?
The primary aims of COPD management are to:
Reduce symptoms (e.g., cough, dyspnea).
Improve quality of life.
Prevent exacerbations and slow disease progression.
Improve exercise tolerance and physical activity.
Optimize oxygenation and prevent complications like cor pulmonale.
How do you assess the severity of acute and chronic COPD?
Acute COPD exacerbations: Severity is assessed via ABG (arterial blood gases) for hypoxemia and hypercapnia, pulse oximetry, respiratory rate, and clinical signs such as dyspnea.
Chronic COPD: Severity is assessed with spirometry (FEV1/FVC ratio < 0.7), mMRC dyspnea scale, COPD Assessment Test (CAT), and FEV1 percentage predicted.
What are the investigations used in the assessment of a COPD exacerbation?
Arterial blood gases (ABG): To evaluate oxygenation and carbon dioxide retention.
Chest X-ray: To rule out pneumonia or pneumothorax.
Spirometry (if not done recently): To assess the degree of airflow obstruction.
Electrocardiogram (ECG): To assess for signs of cor pulmonale or arrhythmias.
Blood tests: To check for infection (e.g., CBC) or other underlying issues.
What are the classes of drugs and modes of delivery available in the management of obstructive lung diseases (asthma and COPD)?
Bronchodilators:
Short-acting beta-agonists (SABA): e.g., Salbutamol.
Long-acting beta-agonists (LABA): e.g., Salmeterol, Formoterol.
Short-acting anticholinergics (SAMA): e.g., Ipratropium.
Long-acting anticholinergics (LAMA): e.g., Tiotropium.
Corticosteroids:
Inhaled corticosteroids (ICS): e.g., Beclometasone, Budesonide.
Oral corticosteroids (for exacerbations).
Combination inhalers: e.g., ICS + LABA or LAMA + LABA.
Delivery methods:
Metered-dose inhalers (MDI), Dry powder inhalers (DPI), Nebulizers.
What are the non-pharmacological aspects of COPD management?
Smoking cessation: The most important intervention to slow disease progression.
Pulmonary rehabilitation: Exercise training, education, and psychological support to improve physical function and quality of life.
Oxygen therapy: For patients with severe hypoxemia.
Nutritional support: Prevent malnutrition and weight loss in advanced COPD.
Vaccinations: Influenza and pneumococcal vaccines to prevent respiratory infections.
What is the role of patient education in the management of COPD?
Improve adherence to medications and inhaler technique.
Encourage smoking cessation.
Promote self-management of exacerbations (e.g., recognizing early symptoms).
Educate on lifestyle changes (exercise, diet, avoiding triggers).
Provide support for pulmonary rehabilitation and oxygen therapy
How does the management of asthma differ from COPD?
Asthma:
Reversible airway obstruction, often with allergic triggers.
Inhaled corticosteroids (ICS) are the cornerstone of management, with SABAs used for acute symptoms.
LABA and leukotriene modifiers may be added in persistent cases.
Treatment is often adjusted based on symptom control.
COPD:
Irreversible airflow limitation often due to smoking.
Long-acting bronchodilators (LABA/LAMA) and ICS are commonly used, with oxygen therapy in severe cases.
Treatment is focused on symptom management and preventing exacerbations.
What are some important treatment strategies for the palliation of COPD?
Oxygen therapy for hypoxemia.
Palliative care for symptom relief (dyspnea management, end-of-life care).
Non-invasive ventilation (NIV) in cases of respiratory failure.
Opioid analgesics for severe dyspnea in advanced stages.
Anxiolytics or sedatives for anxiety and distress.
Advanced care planning to address patient preferences for end-of-life care.
