COPD Flashcards
(10 cards)
What is COPD?
COPD is a obstructive airways disease with no to little reversibility characterised by shortness of breath, cough, and sputum production
How is it COPD different from asthma?
COPD usually has no to little reversibility
Asthma has a far stronger inflammatory component
What causes COPD?
COPD is primarily caused by smoke inhalation (cigarettes being the most common).
The most relevant genetic cause is Alpha-1-antitrypsin deficiency
How do you diagnose COPD?
Post bronchodilatory spirometry showing FEV1/FVC <0.7
What is the MRC dyspnea scale?
It is a measure of how short of breath a person is:
Grade 1: Breathless with strenuous exercise
Grade 2: Short of breath when hurrying or walking up a slight hill
Grade 3: Walks slower than people of the same age on level ground due to breathlessness or has to stop to catch breath
Grade 4: Stops to catch breath after walking about 100 yards or after a few minutes on level ground
Grade 5: Too breathless to leave the house or breathless when dressing or undressing
How do you treat an exacerbation of COPD?
Initial management may include prednisolone 30mg for 5 days and antibiotics (e.g. doxycycline for 5 days)
If hospitalised they may also need nebulisers:
Salbutamol 2.5mg QDS and PRN
Ipratropium 500mcg QDS
What dose steroids do you use in COPD compared to asthma?
COPD = 30mg OD for 5 days
Asthma = 40mg OD for 5 days (due to it being a far more inflammatory process)
What is the DECAF score?
The DECAF score is a clinical, serological, and radiological scale which can be effectively utilized in predicting mortality risk in patients with acute exacerbation of COPD.
What are the criteria for NIV in COPD exacerbations?
Patients must have persistent T2RF with Respiratory acidosis that has failed usual medical management (at least 45min to 1 hour of nebs, steroids, abx)
When should you refer an IECOPD patient to a Reg and ITU?
Pragmatically:
- decompensated T2RF for NIV need to be escalated to registrars
- those who do not improve on NIV and are for full escalation should also be referred to ITU
