COPD Therapeutics Flashcards
(23 cards)
What are the 2 conditions of COPD?
- Chronic bronchitis: Inflammation of bronchi
- Emphysema: Damage to alveolar walls
What are some causes of COPD?
- Smoking
- Air pollution
- Alpha-1 antitrypsin deficiency
What can causes of COPD like smoking trigger?
Inflammation -> Attract neutrophils and macrophages -> damage lung tissue
What are some symptoms of COPD?
- Chronic cough
- Sputum production
- Breathlessness
What is the main test carried out for the diagnosis of COPD?
Spirometry
-> FEV1/FVC <0.7 after bronchodilator -> COPD
-> Not reversible
What can be used to assess the severity of COPD?
- mMRC to assess breathlessness
- CAT score to assess symptoms
- Exacerbation history
What is the first line treatment for COPD?
Bronchodilators
Give general examples of bronchodilators and examples of drugs.
SABA - Salbutamol
LABA - Salmeterol
LAMA - Tiotropium
What is treatment is given during mild COPD?
SABA
What treatment is given if you have mild COPD and you experience more symptoms?
SABA + LAMA/LABA
What treatment is given in severe COPD?
LABA + LAMA
When is an ICS given to a patient with COPD?
- Frequent exacerbations
- Eosinophils >300
An increase in use of ICS in COPD patients can lead to an increase in what?
Risk of pneumonia
What treatment is given if a patient remains uncontrolled on a dual LABA + LAMA therapy?
Triple therapy
LABA + LAMA + ICS
What are some signs of exacerbations?
- Worsening SOB
- Increased sputum
- fever
How do we manage a COPD exacerbation intially?
Increase SABA use
-> 2 puffs every 4-6 hours
-> can use SABA and SAMA
How is a SABA delivered to a patient with a COPD exacerbation?
Via a spacer -> mild/moderate symptoms
Nebuliser -> severe
What is given to a patient for a COPD exacerbation after the use of a SABA?
Oral corticosteroid -> prednisolone
-> 30mg once daily for 5 days
What is given to a patient with a COPD exacerbation and increased purulence or sign of infection?
Antibiotics
-> Amoxicillin 500mg TDS for 5 days
-> Doxycycline 200mg intially, then 100mg OD for 4 days
What is given to a patient if they are hypoxic?
Oxygen
What happens to a patient if you give them oxygen and they are a CO2 retainer?
Hypercapnic
Too much oxygen -> worsens hypercapnia -> respiratory acidosis -> drowsiness -> coma
What are other ways to help support patients with COPD?
- Fluids -> prevent dehydration
- Nutritional support
- Physiotherapy - airway clearance
What condition should you monitor for for a patient with an exacerbation of COPD?
Respiratory failure
