COPD Introduction Flashcards
(20 cards)
What is emphysema?
A type of COPD that damages the air sacs in the lungs, making it harder from them to exchange oxygen and carbon monoxide
Chronic Bronchitis
A type of COPD that causes inflammation and irritation in the lining of the airway,leading to a persistent coughing and mucus production
COPD
A group of lung diseases that make it harder to breathe and get worse over time, including emphysema and chronic bronchitis
It is preventable, irreversible airway limitation, persistent symptoms
COPD Diagnosis
Chronic or recurrent coughing, sputum production, dysponea or wheezing
Frequent chest infections
History of smoking and or other substances
Exposure to chemicals
Family history of COPD
Spirometer is used to diagnose what?
COPD
COPD Diagnosis:
Spirometer measures the lung function with two key values:
1) Forced expiratory volume in 1 second (FEV1):The volume of air exhaled in the first second of a forced breath
2)Forced vital capacity FVC : the total amount of air exhaled after taking a deep breath
After the patient has had their dose of bronchodilator
FEV1 - Air exhaled in the first second
/ the FVC the total amount of air exhaled
If it’s below 70%, it means that FEV1 is too low so there is an obstruction in the airways = COPD
70%=0.7
COPD patient advice
Smoking cessation is the single most effective intervention
Reduce the risk of developing COPD and slows its progression, consider this as a treatment and not an option
Refer patient to in house smoking cessation service
- smoking also reduces the effectiveness of ICS so might need higher doses of ICS - may need higher dose but could cause potential resistance to steroid
Patient advice
Refer to pulmonary rehab
Excercises and breathing techniques to improve physical strength,reduce symptoms or anxiety or depression and make it easier to manage daily routines
Check inhaler techniques at the start of treatment and regularly during treatment. Can they use it?do they use it?
SABA - Salbutamol in COPD treatment
QUICK Relief or asthma symptoms, contraindicated in severe pre -eclampsia, cautions are arrhythmias and hypokalaemia, fine tremor in hands, hypokalaemia and palpitations are also side effects.
Use when needed
LABA- Formoterol,Salmeterol,Indacterol,Vilanterol
Prevents asthma symptoms
Contraindicated in severe pre eclampsia
Caution in arrhythmias and hypokalaemia, side effects - fine tremor,hypokalaemia, palpitations.
Use regularly!!
SAMA - Ipratropium
- Quick relief of symptoms in COPD/Asthma
- no contraindications
- prostatic hyperplasia
- side effects - dry mouth,cough and headaches
- Not commonly used in asthma
LAMA- Aclidinium, Glycopyrronium, Umeclidimium, Tiotropium
Maintenance treatment in COPD
Contraindicated in cystic fibrosis
Tiotropium licensed in less than 6 years
Caution - prostatic hyperplasia
Side effects - dry mouth, cough and headaches
Tiotropium used in asthma and COPD, the test are only licensed for COPD
ICS - inhaled corticosteroids
Beclometasone, budesonide, fluticosone, ciclosonide, mometasone
Indication - long term asthma control
Contraindications- Apply to oral and IV use only
Side effects - oral candidiasis, voice alteration - low raspy voice
Unique features - rinse mouth after use to prevent thrush
LABA + ICS COMBO
Examples - fostair, wockair,symbicort,relvar,lofrabec
Indicated in COPD - also licensed in asthma
ICS+LABA+LAMA - Triple therapy
Trimbow,trelegy,trixeo
COPD - trimbow pMDI licensed in asthma
Mucloytics- like carbocisteine - reduces viscosity of mucus and makes it easier to cough up
Used for chronic coughing,sputum in COPD
Contraindicated indicated in active peptic ulcers
Caution - history of peptic ulcers
Se- Gi haemorrhage,skin reactions,Steven’s Johnson,vomitting
2 TDS then reduce as condition improves !
L
Lon term oxygen and Alert cards
Severe COPD + Hypoxia - low oxygen
Patients who have had episodes of hyper panic respiratory failure - too much co2 in blood
