COPD
Persistent limitation of airflow to lungs
Pump system of lungs become more thickened due to long term exposure to smoking or noxious substance also mucous production lead to cough and sputum production
Progressive can prevent deterioration It cannot be cured and it usually gets worse over time. But there are treatments that can help.
Needs long term treatments
First assess the severity mild moderate severe on the history and lung functions (breathlessness, impact on activities, cough and sputum , frequency of exacerbation )
Rule out α1-antitrypsin deficiency, Asthma, OSA, GORD, Sinusitis
Assess comorbidities and complications – Chest Xray, CTS, ABG, routing blood
Optimize function – physiotherapy, exercise, avoid air pollution or occupational exposure , support stop smoking , early detect and control exacerbation ,immunisation ( PESCI OSX ), oxygen , referral for surgery
Prevent deterioration by regular review , SABA, SAMA, LABA , LAMA, Steroid , Combination , O2, respiratory specialist , community nurse , respiratory nurse ——- SAMA+SABA–à add LABA or LABA /LAMA -à steroid , LABA/Steroid , Triple therapy
Develop plan of care – COPD action plan , GPMP , Pulmonary rehabilitation , education, redflags,
Education – Exacerbation: increased amount of sputum production, change in sputum colour, coughing , fevers, wheezing, chest tightness/pain, fatigue
assess CVS risk NAFILD Risk CKD risk
risk of lung cancer pneumonia
4R
