COPD Flashcards
a ‘common, preventable and treatable disease characterised by non-fully reversible persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the
airways and the lung to noxious particles or gases.
Chronic obstructive pulmonary disease (COPD)
COPD
It is the_______leading cause of death and the
______leading burden of disease in Australia, affecting
12.4% of Australians between 45 and 70 years.
fourth
third
________ is undoubtedly the major cause
of both chronic bronchitis and emphysema, although
only 10–15% of smokers develop the diseases
Cigarette smoking
Occupation at risk for COPD
Occupation: related to cadmium, silica, dusts
Other factors asstd with COPD
- Familial factors: genetic predisposition
- Alpha 1 -antitrypsin deficiency (emphysema)
- Bronchial hyper-responsiveness
Reco for MX of COPD
Confirm diagnosis, Optimise
function, Prevent deterioration, Develop a selfmanagement
plan and manage eXacerbations
Main Sx of COPD
- Breathlessness
- Cough
- Sputum production
Sx with advanced disease
- Fatigue
- Anorexia
- Weight loss
T or F
The sensitivity of the physical examination for
detecting mild to moderate COPD is poor.
T
COPD signs
• __________—always breathless
_________—oedematous and central cyanosis
‘pink puffer’
• ‘blue bloater’
It is
unwise to make a diagnosis of chronic bronchitis
and emphysema in the absence of cigarette smoking
unless there is a family history suggestive of ______
alpha 1 -
antitrypsin deficiency
________ remains the gold standard for diagnosing,
assessing and monitoring COPD. The PEFR is not a
sensitive measure.
Spirometry
Definition of COPD based on PFT
Post-bronchodilator FEV 1 /FVC of <0.70 (<70%)
and FEV 1 <80% predicted
The Australian stages of severity of COPD is based on FEV 1 % predicted
mild
moderate
severe
are mild (60–80%) moderate (40–50%) and severe (<40%),
GOLD staging of severity of COPD is based on FEV 1 % predicted:
- mild ( ≥ 80%),
- moderate (50–80%),
- severe (30–50%),
- very severe (<30%)
ABG of advanced COPD
• PaCO 2 ↑; PaO 2 ↓ (advanced disease)
ECG of COPD
• This may show evidence of cor pulmonale
The only treatment proven to slow the progression of COPD is________
smoking cessation.
In the long-term treatment of COPD, _________
are recommended for the relief of wheezing and
shortness of breath
bronchodilators
Examples of short acting bronchodilators
These include short-acting β 2 -
agonists (SA β As e.g. salbutamol, terbutaline) and
short-acting anticholinergic drugs (ipratropium
bromide);
Examples of LABA
long-acting β 2 -agonists (LA β As e.g.
eformoterol, salmeterol); long-acting anticholinergic
drugs with muscarinic antagonist action (LAMAs e.g.
tiotropium, glycopyrronium)
The evidence suggests that an _______ and _______ are as effective as a nebuliser, but the appropriate method depends on patient needs and preference
MDI and space
____________ can be used in patients
who remain symptomatic despite treatment with
combinations of short-acting bronchodilators and
those with frequent exacerbations.
Long-acting β 2 -agonists
___________ has been proven to
reduce the frequency of exacerbations with COPD
compared with short-acting anticholinergic drugs
Long-acting anticholinergic therapy with tiotropium
bromide (taken by inhalation)
