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7 Cards in this Set
- Front
- Back
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COPD
Characterization |
airflow limitation - not fully reversible
progressive abnormal inflammatory response of lungs to noxious particles of cases |
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COPD
Presentation |
SOB
Cough and sputum production Hx of cigarette smoking respiratory and heart failure |
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COPD
pathophysiology |
usually caused by long-term smoking or exposure to other noxious particles
chronic inflammation in airways but different cells and mediators than asthmatics (so inh corticosteroids don't work as well) |
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COPD
Diagnostic criteria |
Hx of cig smoking or exposure to other noxious particles of fumes
Chronic cough and sputum production Spirometry - ↓ FEV1 (forced expiratory volume in 1 sec) rule out other lung dz |
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COPD
Treatment principles |
Bronchodilators - central to Sx treatment
-↑exercise capacity w/o improving FEV1 - inhaled preferred over oral for initial tx - LA are more effective and convenient but cost more tiotropium (Spiriva)-logical 1st choice for maintenance tx in mod to sev COPD SAB2A preferred for prn use in pts already receiving LAB2A and anticholinergics Theophylline logical step 3 for maint tx in pts not controlled on BAs & anticholiners |
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COPD
TX at each stage |
Stage 0: no drug treatment
Stage 1: prn SA bronchodilator Stage 2: add 1 + LA bronchodilators Stage 3: add inhaled corticosteroids Stage 4: -consider surgical treatment -longterm Oxgn tx if resp failure |
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COPD
Drug TX for acute exacerbations |
inhaled albuterol and/or ipratropium
systemic corticosteroids - eg pred. 40mg daily for 10 days oral antibiotics for purulent sputum - Bactrim or amoxicillin or doxycycline Oxygen |
