logging in or signing up COPD pattersonby Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 9391 Category: Education License: All Rights Reserved Like it (0) Dislike it (0) Added: October 10, 2008 This Presentation is Public Favorites: 4 Presentation Description No description available. Comments Posting comment... By: ms1987 (35 month(s) ago) very comprehensive.. Saving..... Post Reply Close Saving..... Edit Comment Close By: shysha (40 month(s) ago) Nice presentation Saving..... Post Reply Close Saving..... Edit Comment Close By: drrajatchest (50 month(s) ago) this presentation can help medical students for better understanding of copd Saving..... Post Reply Close Saving..... Edit Comment Close By: msutton (62 month(s) ago) This would help with a presentation on COPD for nurse orientees. Could you share it with me please? Meredith Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript COPD: COPD Brooke Y. Patterson, PharmD, BCPS NU 7080 Advanced Pharmacology Research College of NursingEpidemiology: Epidemiology 4th leading cause of death in the US Women > Men in recent years Smoking is primary risk factor for COPD Female smokers are more than 13X more likely to die of COPD than non-smokers 12 million Americans diagnosed 20 million more with early evidence of COPDDefinition: Definition COPD is a syndrome of chronic limitation in expiratory airflow encompassing emphysema or chronic bronchitis Chronic bronchitis: persistent cough + sputum production for most days out of 3 months in at least 2 consecutive years Emphysema: abnormal permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by a destruction of their walls and without obvious fibrosisDiagnosis: Diagnosis H/o exposure to risk factors Tobacco smoke Occupational dusts or chemicals Smoke from home cooking and heating fuels Spirometry is gold standard FEV1/FVC <70% and post-bronchodilator FEV1 <80% confirms presence of airflow limitationFactors Determining Severity of COPD: Factors Determining Severity of COPD Severity of symptoms Severity of airflow limitation Frequency and severity of exacerbations Presence of complications of COPD Presence of respiratory insufficiency Co-morbidities General health status # medications needed to manage diseasePharmacologic Treatment of COPD: Pharmacologic Treatment of COPDManagement By Severity: Management By SeverityPharmacotherapeutic Managment: Pharmacotherapeutic Managment Bronchodilator medications are mainstay of therapy in COPD Beta-agonists and anticholinergics Combining bronchodilators may improve efficacy and decrease the risk of ADRs compared with increasing dose of a single bronchodilator Steroids in stable COPD Only for symptomatic COPD patients with documented response to steroids on spirometry Combined with long-acting beta-agonist is more effective than individual components Should be used in only 10-20% of COPD paitientsShort-Acting Beta2-Agonists: Short-Acting Beta2-Agonists Albuterol (Proventil®, Ventolin®) 2 puffs TID-QID prn Recent supply and re-formulation issues have limited supply and increased cost Metaproterenol (Alupent®) 2 puffs TID-QID prn Levalbuterol (Xopenex®) 2 puffs TID-QID prn Recently available as MDI inhaler Less beta-1 activity; therefore less adverse effects Pirbuterol (Maxair®) 2 puffs TID-QID prnLong-Acting Beta2-Agonists: Long-Acting Beta2-Agonists Slow onset of action; not for acute symptoms 'Controller' inhaler Adverse Effects (less profound due to longer onset of action) Tremor Tachycardia Salmeterol (Servent®) 2 puffs BID Formoterol (Foradil®) 1 cap inhaled BIDAnticholinergic Agents: Anticholinergic Agents Minimal cardiac stimulatory effects compared to those of beta agonists Ipratropium (Atrovent®) 2 puffs QID Tiotropium (Spiriva®) 1 cap inhaled QD Ipratropium/albuterol (Combivent®) 2 puffs QID Adverse Reactions Dry mouth DizzinessTheophylline: Theophylline Use highly NOT recommended MANY drug interactions and adverse effectsOther Pharmacologic Treatments: Other Pharmacologic Treatments Smoking cessation Only intervention that slows loss of lung function Influenza vaccine yearly Pneumococcal vaccine NOT recommended Antibiotics Mucolytic agents Antioxidant agents Antitussives LT modifiersQuestions?: Questions? Contact me at email@example.com You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.