Management of COPD Flashcards
Why do patients with COPD often get breathless?
Their diaphragm is already pushed down so hard trying to breathe on top of that
Why do patients with COPD have a cough and recurrent infection?
Their airway is inflamed
What does smoking do which increases the chance of COPD?
They inactivate the antiprotease which increases neutrophils and elastases which degrade the tissue
Describe how COPD is not just a respiratory disease alone
There is loss of weight and muscle mass
Cardiac disease but also the fact that COPD is a psychosocial disease with depression and anxiety being relatively common in patients
How many people in the UK are diagnosed with COPD?
1 million but estimated there are about 2 million people who are undiagnosed
Name some things which would make you suspect someone has COPD
They are over 35 years old and are or in the past were a smoker
Some symptoms would be cough with sputum, breathlessness, chest tightness and the fact the disease is progressive so the symptoms are worsening over a period of time
Briefly describe the differences between COPD and asthma
Asthma occurs at any age and is very variable often with symptoms during the night with a family history and perhaps other allergies including things like eczema and hayfever
COPD on the other hand is linked to lifestyle particularly smoking more than genetics and symptoms are persistent
Explain the signs you would be looking for in a patient suspected of having COPD
Reduced chest expansion but with a barrel inflated chest. Also using accessory muscles for breathing
Name some signs of respiratory failure
Cyanosis
tachypnoea
pursed lip breathing
Peripheral oedema
Name the 6 baseline tests for COPD
Spirometry Chest xray ECG full blood count BMI AIAT if under 50 years old
List some ways of interventing when someone is discovered to have COPD
Smoking cessation
Inhalers
vaccines
Long term oxygen therapy
Describe briefly what pulmonary rehabilitation can involve
Educate the patient about nutrition and exercise and how to cope with these and also psychologically
Name some short acting bronchodilators
SABA - salbutamol and SAMA
Name the long acting bronchodilators
LAMA and LABA
State the transition of inhaled therapy in a patient whose symptoms are not improving
SABA
Then a long acting bronchodilator
Then another long acting bronchodilator
Then triple therapy with steroids
