Management of COPD Flashcards

1
Q

Baseline Tests for COPD

A
Spriometry
CXR
ECG (may be CV)
FBC (hypoxaemia/eosinophilia)
BMI
ALT
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2
Q

Complications of COPD (8)

A
AECOPD
Pneumonia
Macro-nutrient deficiency
Wasting muscle atrophy
Polycythemia
Cor Pulmonale
Depression
Pneumothorax
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3
Q

What causes Polycythemia

A

Chronic hypoxia
Kidneys compensate and produce more erythropoietin
This leads to an increase in Hb and RBC synthesis

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4
Q

What is Cor Pulmonale

A

Right ventricle hypertrophy and dilation caused by hypoxic vasoconstriction and pulmonary hypertension

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5
Q

COPD Interventions

A
Smoking cessation
Inhalers
Vaccines
Pulmonary rehabilitation
Long term oxygen therapy
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6
Q

Short Acting Bronchodilators

A

SABA

SAMA

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7
Q

What are SABA

A

Short acting beta agonist (Salbutamol)- relaxation of smooth muscle of lungs

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8
Q

What are SAMA

A

Short acting muscarinic antagonists (Ipratropium) Bronchial vasodilation

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9
Q

Long acting Bronchodilators

A

LABA

LAMA

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10
Q

What are LABA

A

Long acting B2 agonist (Salmeterol)

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11
Q

What are LAMA

A

Long acting muscarinic antagonist (Umeclidium, Tiopirum)

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12
Q

What is always given in combination with bronchodilators

A

High dose inhaled corticosteroid

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13
Q

High dose inhaled corticosteroid

A

Relvar (Fluticasone/Vilanterol)

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14
Q

What level of oxygen are given to hypoxic patients

A

Low levels as they are breathing through hypoxic drive

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15
Q

Symptoms of AECOPD (6)

A
Increasing breahlessness
Cough
Sputum volume
Sputum purulence
Wheeze
Chest tightness
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16
Q

Management of AECOPD (4)

A

SAB (Salbutamol and/or Ipratropium)
Nebulisers if inhalers cannot be used
Steroids
Antibiotics (if there are signs of infection)

17
Q

Investigations for AECOPD

A
FBC
Biochemistry and glucose
Theophylline concentration
Arterial blood gas
ECG
CXR
Blood culture (if febrile)
Sputum microscopy, culture and sensitivity
18
Q

Ward based management for AECOPD

A
Oxygen-target saturation
Nebulised bronchodilators
Corticosteroids
Antibiotics
Assess for evidence of respiratory failure (NIV)