PT7: COPD Flashcards
what is COPD
airflow obstruction that is irreversible
what is the main cause of COPD
smoking
what is FEV1
forced expiratory volume; maximum amount of air expired in one second
what is FVC
vital capacity, the amount of gas remaining at the end of normal respiration
what is FEV1/FVC
ratio of forced expiratory volume in one second to forced vital capacity
this is reduced in COPD
what is chronic bronchitis
daily productive cough that lasts for three months of the year and at east two years in a row
what is emhysema
damage to the air sacs in the lungs
what are the clinical features of COPD
exertional dyspnoea, cough, sputum production, wheeze, symptoms are fixed while disease course is progressive
what assessment tools are used for COPD
COPD assessment test chronic respiratory questionnaire st george's respiratory questionnaire chronic respiratory questionnaire modified medical research council questionnaire
what type of inhalers are used in triple therapy
LAMA, LABA, ICS
when would you consider triple therapy
pts taking LABA/LAMA who have a severe exacerbation, two moderate exacerbations within a year, three month trial if symptoms affect daily life
what drugs are used in a trimbow inhaler
beclometasone, formoterol, glycopyrrolate
when is step-down from triple therapy considered
pts treated with ICS/LABA/LAMA but have never suffered exacerbations
what are some examples of oral treatments used in COPD
corticosteroids, mucolytics, theophylline, prophylactic antibiotics, rolflumilast
what is roflumilast
long-acting selective phosphodiesterase-4 enzyme inhibitor that targets cells and mediators believed to be important in COPD
what are some examples of acute exacerbations
increased SOB, worsening cough, increased sputum production, change in sputum colour
how can exacerbations be prevented
flu vaccines, optimise inhaler therapy, education, emergency abx/steroids at home
how can medical management be optimised
controlled oxygen, bronchodilators, systemic steroids, antibiotics, mucolytic, thromboprophylaxis
what is a venturi mask
delivers O2 from 24% to 60% with flow rates from 4 to 12L/min
minimal CO2 build up
when does respiratory failure occur
when disease of the heart or lung leads to failure to maintain adequate blood oxygen levels or increased blood CO2 levels
what is respiratory failure defined by
arterial partial pressure less than 8kPa of O2 or arterial pressure of CO2 greater than 6.7kPa
