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