NEW COPD Flashcards
(29 cards)
What is COPD?
A common, preventable, and treatable disease with persistent respiratory symptoms and progressive, not fully reversible airflow limitation due to small airways disease and emphysema.
What are common symptoms of COPD?
Dyspnoea, wheeze, chronic cough, and regular sputum production.
What are the main risk factors for developing and exacerbating COPD?
Tobacco smoking, environmental pollution, occupational exposures, genetic factors (e.g., alpha-1 antitrypsin deficiency), and poor lung growth in childhood.
What complications can arise from COPD?
Cor pulmonale, type 2 respiratory failure, secondary polycythaemia, anxiety, and depression.
What is asthma-COPD overlap syndrome (ACOS)?
A condition with persistent airflow limitation featuring both asthma and COPD characteristics.
What is the primary aim of COPD treatment?
To reduce symptoms and exacerbations, and improve quality of life.
What non-drug treatments are recommended for COPD?
Smoking cessation, pulmonary rehabilitation, physiotherapy, nutritional support, and multidisciplinary care.
When should pulmonary rehabilitation be offered?
To patients who feel functionally limited by COPD.
What breathing technique can help with sputum clearance?
Active cycle of breathing techniques and positive expiratory pressure devices.
When should patients be referred to a dietitian?
If BMI is abnormal or changing, especially in elderly patients.
What vaccinations are recommended for all COPD patients?
Annual inactivated influenza vaccine and pneumococcal vaccine.
What is the initial treatment for all COPD patients?
A short-acting bronchodilator (SABA or SAMA) as needed.
What is the next step if a patient remains symptomatic or has exacerbations?
Start LABA + LAMA combination therapy.
When should ICS be added to LABA + LAMA (triple therapy)?
After ≥1 severe or ≥2 moderate exacerbations in one year.
What if symptoms persist but exacerbations are not frequent?
Trial ICS for 3 months; continue only if there’s improvement
What is the initial treatment for COPD with asthmatic features?
LABA + ICS.
When should LAMA be added to LABA + ICS (triple therapy)?- asthmatic
After severe or multiple moderate exacerbations or poor symptom control.
When can azithromycin prophylaxis be considered?
In non-smoking patients with ≥4 exacerbations/year or hospitalised exacerbations, despite optimized treatment.
What assessments are needed before starting prophylactic azithromycin?
Sputum culture, thoracic CT, ECG, and liver function tests.
How often should azithromycin prophylaxis be reviewed?
After 3 months, then every 6 months.
When are mucolytics indicated?
For patients with chronic cough and sputum; continue only if beneficial.
When is theophylline considered?
When inhaled bronchodilators are ineffective or unsuitable.
What treatment is recommended during an exacerbation at home?
Short-acting bronchodilators, oral corticosteroids, and antibacterials (if indicated).
What should be done if the patient is taking azithromycin prophylactically and has an exacerbation?
Use a non-macrolide antibiotic if needed.
