Pharmaceutical Care of COPD Flashcards
what is COPD?
Increased airway resistance due to chronic inflammation as a result of activation of macrophages, neutrophils and leukocytes that causes
airway and parenchymal damage
what are common factors that cause COPD?
- smoking
- occupational dusts and chemicals
- indoor air pollution
- genetics
- gender
- infection
- socioeconomic status
8 history(HX) of asthma
what are the 4 things that happen when one has COPD?
- narrowing and remodelling of airways
- increased goblet cells
- enlarged mucus-secreting glands in central airways
- vascular bed changes resulting in pulmonary hypertension
what is chronic bronchitis?
in the bronchi, there’s ciliary dysfunction causing:
- decreased airflow
- hypersecretion
- chronic cough
what is emphysema?
in the bronchioles, alveolar ducts and sac. they breakdown and there’s a loss of alveolar integrity so less elastic recoil
what are the symptoms of COPD?
- exertional SOB (measured on MRC dyspnoea scale)
- chronic cough
- sputum
- wheeze
- tight chest
what factors helps to diagnose COPD?
-weight loss
-waking at night
-ankle swelling
fatigue
-occupational hazard
-chest pain
-haemoptysis
what are symptoms of emphysema?
- thin
- barrel chest
- cyanosis
- pursed lip breathing
- prolonged expiratory time
what are symptoms of chronic bronchitis?
- overweight
- airflow issues
- hypoxia
- clubbing
- cardiac enlargement
- peripheral oedema
what is used to provide symptomatic relief of breathlessness and exercise limitation?
SAMA or SABA
what is used to prevent/treat exacerbations or persistent breathlessness?
LABA or LAMA or LABA and ICS combined (and stop SAMA)
What is used to treat persistent exacerbations and persistent breathlessness?
LABA + ICS
what is used for COPD treatment if there’s severe symptoms and the first 3 lines of treatment don’t work?
LABA + ICS + LAMA
what other non-inhaled therapies are there for COPD?
- oral theophylline
- oral corticosteroids
- nebulised bronchodilator and/or aminophylline IV
- oral mucolytics
- antibacterials
- LTOT (long-term oxygen therapy)
what are some non-pharmacological interventions for reducing COPD likelihood and exacerbations?
- pulmonary rehabilitation (e.g. exercise)
- smoking (reduce amount smoked til they stop smoking completely-NRT)
