COPD Flashcards Preview

Respiratory Diseases > COPD > Flashcards

Flashcards in COPD Deck (14)
Loading flashcards...
1
Q

what is COPD split into

A

chronic bronchitis and emphysema

2
Q

what is chronic bronchitis

A

chronic irritation, defensive increase in mucus production and epithelial cell numbers (especially mucus glands)
non-reversible obstruction (some may have reversible asthmatic component)

3
Q

what is emphysema

A

tissue destruction in the alveoli leading to loss in alveolar walls and increase in size of airspaces distal to terminal bronchiole (without fibrosis)

4
Q

what causes it

A

smoking
passive smoking
fumes
dust

5
Q

what are symptoms

A
develop over number of years
increasing breathlessness
persistent cough with sputum 
frequent exacerbations
wheezing 
weight loss
malaise 
swollen ankles
increased infection risk
6
Q

how is it diagnosed

A

spirometry - decrease in PERF, FEV1, FVC and TLCO
FEV1/FVC <75%
FEV1 response to B2 <15%
CXR - lung infiltrates if infection
Blood test - rule out other cause
Sputum culture - grow organism causing exacerbation

7
Q

1st line treatment

A
SABA (salbutamol)
or SAMA (ipratropium)
8
Q

2nd line treatment (if FEV1>50%)

A
LABA (salmeterol)
or LAMA (tiotropium) and discontinue SAMA
9
Q

3rd line treatment (if FEV1<50%)

A
LABA (salmeterol) plus ICS (becomethasone, budesonide, prednisolone)
or LAMA (tiotropium) and discontinue SAMA
10
Q

4th line treatment

A

LAMA (tiotropium) plus LABA (salmeterol) plus ICS

11
Q

5th line treatment

A

if patient has 2 or more exacerbations in 12 months despite triple therapy, PD4 receptor antagonist (roflumilast) used

12
Q

what is used in acute exacerbation

A

oral corticosteroids (prednisolone) and antibiotics

13
Q

1st line antibiotics?

A

doxycycline / amoxicillin

14
Q

2nd line antibiotics?

A

clarithromycin, moxifloxacin, (AND IV aminophylline (methylxanthine))