COPD Lecture Flashcards
Increased cough
Increased sputum
Worsening dyspnea
COPD exacerbation
Wheezing
Tachypnea
Increased resp efforts (work of breathing, tripodding, DOE, accessory muscles)
Hypoxia
physical exam of COPD exacerbation
normal spirometry does not rule out empysema, chronic bronchitis, asthma or risk of developing exacerbations of COPD
SG 0
MILD severity guide
FEV1 > 60% predicted
SG 1
MODERATE severity
FEV 1 < 60% predicted
SG 2
SEVERE severity guide
FEV 1 < 30% predicted
SG3
SG 1- SG 3:
post bronchodilator FEV1/FVC ratio is < ____
< 0.7
FEV1/FVC ratio is >0.7
FEV 1 <80% predicted
seen with restriction, muscle weakness, etc
SG U: undefined
What is considered severe hypoxemia that requires oxygenation in COPD?
resting O2 <88%
PaO2 < 55 mmHg
Cough and sputum most days for last 3 months for at least 2 years
Chronic bronchitis
Oxygen:
- Nasal canula (up to 6L)
- Vapotherm (high flow nasal O2 with positive pressure, “washes out” upper airway)
- Positive pressure ventilaton (BiPap, CPap)
- Intubation and mechanical ventilation (need CCU)
COPD tx
(need pulm consult for 2-4)
high flow nasal O2 and positive pressure
“washes out” upper airway expired CO2 replacing it with highly oxygenated O2
used in COPD tx
Vapotherm
What 2 classes of meds are used as inhalants in COPD tx?
Beta adrenergic agonists
Anticholinergics
Produces bronchodilation
ie albuterol
Beta adrenergic agonists
Relaxes smooth muscle, enhancing dilation effects of beta adrenergics
ie..ipratropium, tiotropium
Anticholinergics
