COPD

Question 1

Step 1 treatment for management of COPD

Answer 1

SABA (salbutamol) or SAMA (ipratropium)
- in asthmatic and non-asthmatic features

Question 2

Step 2 treatment for management of COPD

Answer 2

Non-asthmatic: Add LAMA + LABA
- discontinue SAMA (if added in step 1)

Asthmatic: Add LABA + ICS

Continue SABA in all stages
- SAMA can be continued as long as LAMA is not being used

Question 3

When to move up to step 3 of treatment in COPD

Answer 3

If patient has a severe exacerbation OR 2+ moderate exacerbations in 1 year

Question 4

Step 3 treatment in COPD
- when/ what is discontinued after 3 months

Answer 4

Triple therapy: LAMA + LABA + ICS
- discontinue ICS if non-asthmatic has not improvement with triple therapy after 3 months

Question 5

Step 4 treatment in COPD

Answer 5

SPECIALIST
- theophylline
- oxygen therapy
- Mucolytics

Question 6

what vaccine should be offered to those with COPD

Answer 6

Pneumococcal and influenza vaccine

Question 7

What is in a COPD rescue pack?

Answer 7

Prednisolone
- 30mg for 5 days
Antibiotic
- amoxicillin
- doxycycline
- clarithromycin

Question 8

Treatment of COPD exacerbation

Answer 8

1. SABA/ SAMA
2. Prednisolone
3. Aminophylline- if inadequate response to nebulised therpies
4. Oxygen