COPD Flashcards
(19 cards)
What is COPD and how is it characterised?
A common, treatable, largely preventable lung condition with persistent respiratory symptoms and progressive airflow obstruction that is not fully reversible.
What pathological changes cause airflow limitation in COPD?
Small airways disease (obstructive bronchiolitis) and parenchymal destruction (emphysema).
What are the common symptoms of COPD?
Dyspnoea, wheeze, chronic cough, and regular sputum production.
What is the primary risk factor for COPD?
Tobacco smoking.
What spirometry finding confirms COPD?
Post-bronchodilator FEV1/FVC ratio < 0.7.
What vaccines should be offered to all COPD patients?
Pneumococcal and annual inactivated influenza vaccine.
What is the first-line inhaled treatment for all COPD patients?
A short-acting bronchodilator (SABA or SAMA) as needed.
What step-up treatment is offered to COPD patients without asthmatic features?
LABA + LAMA.
When is triple therapy (LABA + LAMA + ICS) indicated in patients without asthmatic features?
Day-to-day symptoms affecting QoL or ≥2 moderate or 1 severe exacerbation per year.
What is the step-up treatment for COPD patients with asthmatic features?
LABA + ICS; if still symptomatic or frequent exacerbations, add LAMA (triple therapy).
What are two side effects associated with inhaled corticosteroids (ICS)?
Pneumonia and increased risk of systemic side effects.
When should prophylactic azithromycin be considered in COPD?
Non-smokers with ≥4 exacerbations/year despite optimal treatment.
What test must be done before starting azithromycin prophylaxis?
ECG (to monitor QT interval).
When should mucolytics be considered in COPD?
In patients with chronic productive cough, only if symptomatic improvement occurs.
When should theophylline be used in COPD?
Only after trial of bronchodilators or if the patient cannot use inhaled treatments.
What should a COPD rescue pack include?
Short course of corticosteroids and oral antibiotics.
What is the standard dose of prednisolone for COPD exacerbation?
30 mg once daily for 5 days.
Name 3 first-line antibiotics for infective COPD exacerbations.
Amoxicillin, doxycycline, clarithromycin.
What should be withheld if SAMA is given during an exacerbation?
LAMA.
