Chronic Obstructive Pulmonary Disease Overview

Contents 

 

 

OVERVIEW

 

Definition of COPD

  • A preventable & treatable disease w/ overall severity contributed by exacerbations & comorbidities
  • The persistent airflow limitation is usually progressive & associated w/ an enhanced chronic inflammatory response in the airways & the lung to noxious particles or gases
  • The chronic airflow limitation is caused by a mixture of small airways disease & parenchymal destruction

Risk Factors for COPD

Host Factors
  • Hereditary deficiency of alpha-1 antitrypsin
  • Airway hyper-responsiveness
    • Includes asthma
    • May also develop after exposure to tobacco smoke or other environmental insults
  • Lung growth & development
    • Individuals may have reduced maximal attained lung function due to processes during gestation & childhood
  • Infections
    • Reduced lung function can be associated w/ a history of severe childhood resp infections
    • Previous tuberculosis
Exposures
  • Tobacco smoke
    • Most commonly encountered risk factor
    • Includes history of tobacco use or prolonged exposure to second-hand smoke
    • Smoking during pregnancy can put the fetus at risk
  • Occupational dusts & chemicals
  • Air pollution
  • Smoke from home cooking & heating fuels
  • Socioeconomic status

Definition of COPD Exacerbation

  • An acute event wherein the patient’s symptoms worsen beyond normal daily variations that leads to change in medication
  • Viral & bacterial respiratory tract infections are the common causes
    • Exacerbations caused by bacterial etiology in 50% of patients
  • Other causes: air pollution, interruption of maintenance medications, other comorbidities (GERD)

Signs & Symptoms of COPD Exacerbation

  • Increased breathlessness, wheezing, chest tightness
  • Increased cough & sputum, change in color &/or tenacity of sputum
  • Fever, malaise, fatigue, depression, confusion, sleep disturbances, decreased exercise tolerance
  • Resp rate >25 breaths/min, heart rate >110/min, use of accessory muscles for breathing &/or dyspnea at rest may indicate severe acute exacerbation

Below is the overview of the disease management of Chronic Obstructive Pulmonary Disease:

COPD 1

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COPD 2

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Arrange For Follow-Up Assessments

  • A follow-up assessment must be carried out w/in 4-6 wk following discharge from hospital for exacerbations
  • Check patient’s ability to cope in his environment
  • Measure FEV1
  • Check inhaler technique
  • Check understanding & ability to follow of treatment regimen
  • Assess need for long-term O2 therapy &/or home nebulizer for patients w/ very severe COPD
  • Check status of comorbidities

 

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Version: 31 July 2015

 

Guideline References:

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