Management Of COPD Flashcards
What are the main symptoms oof COPD
Chronic Cough -chesty cough with phlegm
Dyspnoea- shortness of breath- increased effort to breath, gasping, chest is heavy
Sputum- present with cough- can indicate bacterial manifestation
What do exacerbations of COPD look like
Increased breathlessness
Reduced exercise tolerance
Rapid breathing (tacypnoea)
More frequent in winter
^ exacerbations =^ hospiltalisation= decreased quality of life
What is the major risk factor for COPD
Smoking
And passive smoking
Comorbidities - asthma, chronic bronchitis.
Aging- cumulative exposure.
Occupation
Indoor/ outdoor pollution
HOw do you diagnoses COPD
Considered in any patient.
- > 35-40 years.
- Dyspnoea, chronic cough, sputum
- history to exposure of risk factors - occupation, smoking, indoor/outdoor pollution
MUST conduct Spirometry to confirm diagnosis
What is the major complication with patients who have COPD
Respiratory ACIDOSIS
- symtoms include-
- ACUTE ACIDOSIS -headache, confusion, anxiety, drowsiness
- STABLE ACIDOSIS- memory loss, daytime sleepiness,sleep loss , gait
Symptoms due to amount of CO2 in blood
What is the pharmacology management for COPD- STEP UP method
STEP 1 - Start on SAMA( ipratropium) or SABA ( salbutamol)prn
STEP 2- If having continues Shortness of breath- add LAMA or LABA
— NOTE - SAMA or LAMA can’t be used txt- if pt on SAMA- use LABA.
— LABA mono therapy not recommended
STEP 3-ADD ICS+LAMA+LABA - avoid ICS for no longer than 2 weeks due to increased risk of Pneumonia
STEP 4 For sever COPD add theophylline low dose 100mg bd not recommended normally
What are the non pharmacological therapy
- Reduce smoking
- Immunisation- influenza vaccinations and pneumonia vaccinations recommended for all pt with COPD
- Increase it physical activity in all stages of copd- decreases exacerbations
- Nutrion- obesity and malnutrition are highly prevalent- calculate bmi and reference to nutritional advice
