COPD Flashcards
What is COPD?
An obstructive lung disease characterised by inflammation of small airways (a result of inhaled toxins e.g. smoking).
What is the most common cause of COPD?
Smoking.
Highest prevalence in smokers/ex-smokers over 35 years old.
What genetic predisposition is linked to COPD?
Alpha-1-antitrypsin deficiency.
Results in failure to break down neutrophil elastase.
COPD more likely to develop young age - especially if they smoke.
What are the two pathological components of COPD?
Chronic Bronchitis
Emphysema
What is the pathology involved in chronic bronchitis?
Smoking/Other toxins result in chronic neutrophilic inflammation, producing scarring and fibrosis.
Following this, there is hypertrophy of mucus-secreting glands, alongside hyperplasia of goblet cells.
What is the pathology involved in emphysema?
Inflammation means neutrophils within the tissue. These cells release proteases which break down the elastin walls of the alveoli, meaning they no longer have their elastic recoil function.
How does emphysema affect pulmonary compliance?
This will be abnormally increased.
Can be observed through DLCO testing, which will be reduced.
How does COPD present?
Progressive dyspnoea
Chronic cough
Regular exacerbations
Wheezing on auscultation (due to chronic bronchitis)
Reduced breath sounds on auscultation (due to emphysema).
How does COPD affect spirometry?
Will have decreased FEV1, with normal/ mildly decreased FVC (will be <70%).
What are long-term non-pharmacological options for COPD treatment?
Smoking cessation (will stop worsening)
Pulmonary rehab
Annual pneumococcal and flu jabs
How to treat an acute exacerbation of COPD at home?
Oral prednisolone
Increased dose of SABA/SAMA
Antibiotics (if suspected infective aetiology)
How is an acute exacerbation of COPD treated in hospital?
Think ‘ISOAP’
Ipratropium
Salbutamol
Oxygen therapy (target sats of 88-92%)
Amoxicillin (or doxycycline if allergic)
Prednisolone
What long-term pharmacological options exist for COPD?
This is dependent on the number of exacerbations experienced per year/if been admitted to hospital.
If <2/not been admitted, give LABA and LAMA.
If >2/been admitted, give ICS, LABA and LAMA.
What organism is most commonly responsible for an infective exacerbation of COPD?
Haemophilus influenzae.
