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COPD (Signs/Symptoms (Spirometry is required to confirm the diagnosis. -…
COPD
Signs/Symptoms
Spirometry is required to confirm the diagnosis. - FEV1/FEVC > 70% (postbronchodilator)
Initially asymptomatic until declining lung function leads to significant symptoms
Chronic cough, chronic sputum production, dyspnea on exertion, wheezing
Signs of hyponexia (cayanosis, tachycardia) and signs of cor pulmanae. - severe
Pathophysiology
Primary inflammatory cells are neutrophils, macrophages and CD8 lymphocytes.
Repeated exposure to noxious particles and gases causes chronic inflammation, resulting in pathological changes. An imbalance of proteinases and antiproteinases in the lungs and oxidative stress are also important factors.
The abnormalities are mucus hyper secretion, ciliary dysfunction, airflow limitation, hyperinflation, gas exchange abnormalities, pulmonary hypertension, systemic effects, parenchymal destruction
Treatment
Worsening symptoms
LABA/LAMA. Use both if not managed and if still not managed add theophylline
High exacerbation risk
ICS + LABA/LAMA
LABA + LAMA
ICS + LAMA. But if have chronic brinchitis = PDE-4 inhibitor + LABA.
CHECK CARDIO FOLDER
Treatment outcome
Smoking cessation, reducing symptoms, improving ability to exercise, minimizing rate of lung decline, maintaining or improving quality of life, preventing/ treating exacerbations