Management of COPD COPY Flashcards
Which form of COPD is Airflow obstruction Hyperinflation?
Chronic Bronchitis Emphysema
Is COPD reversible?
Not fully
Is progressive
What is the 3rd leading cause of death in the world?
COPD
How do you diagnose COPD?
- Relevant History (Symptoms)
- Look for clinical signs
- Confirmation of diagnosis and assessment of severity
- Other relevant tests
What are the different ways you can witness respiratory failure?
- Tachypneoa
- Cyanosis
- Use of accessory muscles
- Pursed lip breathing
- Peripheral Oedema
- Ankle swelling, strain on right side of heart
What is the use of spirometry in COPD?
Confirms diagnosis and assesses severity
How do you analyse the results of a spiromtry to confirm COPD?
How do you assess the severity of COPD using FEV1/FVC?
What are the COPD baseline tests?
Spirometry - record absolute and % predicted value
CXR
ECG
FBC - Anaemic, polycthaemic, eosinophilia
BMI - weight, height
AIAT - Age of onset < 50
Anaemia can present as breathlessness
High blood cell count can be a sign of COPD
Polycthaemia = Increased RBC’s
AIAT is antitrypsin
LOOK
What are the different ways COPD is managed
Non-pharmacological
Pharmacological
What are the Non-pharmacological treatments
- smoking cessation
- vaccination (flu yearly + pneumococcal every 5 years)
- pulmonary rehab
- nutritional assessment
- psychological support
What does pulmonary rehabilitation involve?
What are the benefits of Pulmonary Rehabilitation?
What are the ways you can manage COPD?
Prevention of disease progression
Releive breathlessness
Prevention of exacerbation
Management of complications
What is the interventions for the following aims
Prevention of disease progression
Releive breathlessness
Prevention of exacerbation
Management of complications
- Smoking cessation
- Inhalers
- Inhalers, Vaccines, Pulmonary Rehabilitation
- Long term Oxygen therapy
What are the benefits of Pharmacological Management?
- Relieve symptoms
- Prevent exacerbations
- Improve QoL
What the pharmacological management for COPD with SOB
- SABA Salbutamol blue inhaler/Terbutaline
- SABA+LAMA
- SABA+LAMA/LABA (Salmeterol)
What is the treatment for COPD with exacerbation
- SABA+LAMA
- SABA+LAMA/LABA
- SABA+LAMA/LABA/ICS
What are the short acting bronchodilators used for inhaled therapy in COPD?
What are the long acting bronchodilators used to treat COPD?
– Relieve symptoms
– Prevent exacerbations – Improve quality of life
What are examples of High dose inhaled corticosteroids (ICS and LABA)
How does the COPD inhaler treatment progress with severity, symptoms and exacerbation?
When is it appropriate to use Oxygen with a COPD patient
Hypoxia with:
PaO2< 7.3 kPa
PaO2 7.3-8 kPa if:
- with second organ dysfunction
- polycthaemia
- nocturnal hypoxia
- peripheral oedema
- pulmonary hypertension
What intervensions are used at different stages of COPD
What are the symptoms of COPD exacerbation?
Increasing breathlessness
Cough
Sputum volume
Sputum purulence
Wheeze
Chest tightness
What is the effect of AECOPD on alveoli and mucus glands (including goblet cells)?
Alveolar wall destruction and mucus hypersecretion
What does management of AECOPD involve?
- SA bronchodilators (salbutamol, ipratropium)
- Change inhalers
- Oral steroids (Prednisolone)
- Antibiotics
Admit if
- Tachypnoea
- Low O2 < 90-92%
- Hypotension
What are the relevant AECOPD investigations?
FBC
Biochemistry of glucose
Theophyline concentration (in using theophyline concentration)
ABS
ECG
Chest X-Ray
Blood cultures in febrile patients
Sputum Microscopy
What are the different palliative care methods for COPD
Breathlessness/Dysfunctional breathing
Pharmacological - Morphine
Psychological support
Palliative care referral
