Week 2 - Management Of COPD Flashcards
What do we want to treat?
Prevent exacerbations
Weight loss and nutrition
Avoid resp. failure and complications
Co-morbidities
Treat anxiety and depression
What are some non-pharmaceutical treatment options? (5)
Smoking cessation, flu and pneumococcus vax, pulmonary rehab, nutritional assessment, psychological support
What benefit do flu and pneumococcus vaccinations bring?
Reduce likelihood of COPD hospitalisation and mortality rate. Having both is most effectibe
What is the general pharmacological management of COPD? (5)
Inhalers, bronchodilators, steroids, antibiotics or oxygen treatment
Which short acting bronchodilators are used for treatment of COPD?
Salbutamol - SABA
Ipratropium - SAMA - short acting antimuscarinic agent
Which long acting bronchodilators are used for treatment of COPD?
salmeterol - LABA
LAMA (long acting anti-muscarinic agent)
What are some combined inhaled treatments?
relvar or fostair - High dose ICS and LABA combined
When is long term oxygen treatment given for COPD?
If a patient matches certain criteria - stopped smoking for 6 months, hypoxic with pO2 below 7.3kpa
Which investigations are carried out in the hospital in an acute exacerbation?
- Full blood count
- biochemistry and glucose
- theophylline conc.
- arterial blood gas
- sputum sample
- blood culture in febrile patents
- chest x-ray
- ECG
How are patients managed in the ward?
- O2 levels stay at 88-92% (lower) to not suppress ventilatory drive or cause drowsiness
- bronchodilator via nebuliser
- corticosteroids
- Antibiotics if there’s an infection - IV or pill
- Assess for resp. failure
What are the palliative care options for end stage COPD patients?
Patients should have anticipatory care plan. Morphine helps relieve symptoms and psychological support also. Think about signing DNACPR/DNR
