Chronic Obstructive Pulmonary Disease (COPD) – Chronic Treatment

Chronic Obstructive Pulmonary Disease (COPD) – Chronic Treatment

Pathology:                   Umbrella term for emphysemaand chronic bronchitis.

Progressive airway obstruction with little to noreversibility

Emphysema:dilatation and destruction of terminal air spaces

Chronic bronchitis:productive cough on most days for at least 3 months of two successive years.


Aetiology:                     Tobaccosmoking, occupational environments, alpha-1 anti-trypsin deficiency


Symptoms:                  Cough,sputum production, breathlessness and wheeze


Signs:                              Tachypnoea,hyperinflated thorax, lip pursing, plethoric, cyanosis, use of accessorymuscles, quiet breath sounds.


Investigations:          Spirometry: Obstructive pattern

Transfer factor: Reduced in emphysema

Chest X-Ray: Hyperinflation, bullae

HRCT: Examines degree of emphysema


Treatment:                  Smokingcessation, pulmonary rehabilitation, appropriate self management plans (e.g.home steroids and antibiotics). Appropriate oxygen therapy if needed

























Figure 2.7 TreatmentPathway For COPD


Complications:          Infectiveexacerbations, pneumothorax, cor pulmonale, pulmonary hypertension, immobility,weight loss, ventilatory failure


Prognosis:                    Onlystopping smoking and long term oxygen therapy (LTOT) improve prognosis

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