COPD Treatment

Question 1

COPD NICE

Answer 1

1)Offer SABA or SAMA
2) If person is limited by symptoms or has exacerbations despite treatment: No asthmatic feature or feature suggesting steroid response

• offer LABA + LAMA
  Person has day to day symptoms that adversely impact quality of life

Consider 3 month trial of LABA +LAMA+ICS

If no improvement then revert to LABA and lama

Question 2

If person has 1 severe or 2 moderate exacerbations within a year

Answer 2

Consider LABA+LAMA+ICS

Explore further treatment options of still limited by breathlessness or subject to exacerbations

Question 3

Asthmatic features or features suggesting steroid responsiveness

Answer 3

Consider LABA+ ICS

Person has day to dat symptoms that adversely impact quality of life, or has 1 severe or 2 moderate exacerbations within 1 year

Offer laba+lama+ics

Question 4

STEP 1 - Used for quick relief of symptoms
Prescribe ONE inhaler only

Answer 4

SAMA or SABA

Question 5

Step 2 and 3 - treatment with asthmatic features

Answer 5

2) SABA+LABA+ICS

3) Only when the patient has: OME severe exacerbations had to go to hospital within a year or TWO exacerbations

+ LAMA

Question 6

STEP 2 AND 3 - Treatment without asthmatic features

Answer 6

2)SABA+LABA+LAMA

3)Only when the patient has one severe exacerbation - within a year
OR
Two exacerbations
OR
Impacting life

ICS

Question 7

IN practice once treatment is stabilised

Answer 7

Saba + one of the 4 (laba,lama,ics)