Flashcards in COPD Deck (24):
What are the two conditions that COPD is an umbrella term for?
Empysema and chronic bronchitis
What is COPD?
Characterised by airflow obstruction hat is usuallly prgoreesive, and that is not fully reversible
What is empysema?
Is a pathological proccess in which there is destruction of the terminal brochioles and distal airspaces
What is the effect of a destruction of supporting tissue in empysema?
Airways collapse or close in vetnilitaion, and there is airflow obstruction affecting the small airways
What is the effect of the loss of elastic tissue in empysema?
This causes the lungs to hperinflate, as the lungs are unable ot resist the natural movement of the chest wall to expand outwards
What is chronic brochitis?
Chronic mucus secretion, that is often causes by airway inflamtion, which is often caused by smoking
What are the main causes of COPD?
Smoking (the main causes) occuaapational exposures such as coal dust, pollution, alpha 1 antitrypin defincey
What are the symptoms of COPD?
Coungh and sputum production is often the first symptom, and then there is progressive breathlessness
What are some of the signs of COPD?
Purse lipped breathing, tachypneoa, using the accessory muscles to help with breathing, wheeze and quite breath sounds on asculation, hyperinflation, and in more advanced cases there is cyanosis, CO2 reterntion
How does hyperinflation of the lungs cause breathlessness?
As the diaphram and the other muscles and this squishes the diaphram and makes it harder for these muscles to expand the chest cavity
What are some of the features of the spirometery of a COPD paitnet?
The FEV1 <80% the predicted value, and the FEV1/FVC <70%, as there is limited expiration of the air during the first second
What are some of the features of making a diagnosis of COPD?
Breathlessness that is usually persistant and progressive, smoker or ex smoker and a older patietn, and a chronic productive cough as well as the features of spirometery
What is the care bundle in the managment of stable COPD?
Mycolytics, diet- suplpements and a dietican revue, pulmonary rehabiliation, brohcodilators, antimuscarinas steriods, and long term oxygen thearpy as well as supportive treatments such as the flu vacicne
What are some of the drugs that might be used in COPD?
Steriods, inhaled, brochodilators, mucolytics, methylxamines, antimuscarinics
What is the mechanism of action of B2 adrenoreceptors such as salbuatmal?
Ligand binds to the receptor activates the adenyly cyclase which increases the cAMP activating protein kinase A, phosphorylation of downstream targets, reduction of smooth msucle, and this causes brochodiliation
What are some of the adverse effects of B2 agnoists such as salbutamol?
Hypokalmeia, tachcardia, tremor and aniwxity
What is the mechanism of action of anticholdingerics?
Syngersit wiht B2 agnoist
What are the local adverse action of anticholingerics?
Dry mouth and cough, sore mouth, bitter taste and upper resp tract infections
What are some of the systemic effects of anticholingerics?
Supraventiculuar tachcardia and constiplastin, urianry diffculty and atrial fibrillation as well as urainary ifficuluty
What is the mode action of methylaxinlines?
Mode of action include anti inflammtoryies, brochodilation,
What is the mechanism of methylacines?
What are the surgical options for the treatment of COPD?
There is a lung volume reduction and therefore a reduction in hyperinflation, and a lun transplant that may be option in younger patients
How would you manage a acute exaberation of COPD?
Aim for sats 88-92%, and use nebulisers such as brochoidlators, and steriod, antibitotics if there are infective features,