1 / 19

Respiratory Disorders

Respiratory Disorders. Module 2. Chronic Obstructive Pulmonary Disease. Process. Step 1 . Complete Module #2 with voice overlay Step 2 . Answer the question following Module #2 Step 3 . Complete further modules or take a break. Module #2 Learning Objectives.

Thomas
Télécharger la présentation

Respiratory Disorders

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Respiratory Disorders Module 2. Chronic Obstructive Pulmonary Disease

  2. Process • Step 1. Complete Module #2 with voice overlay • Step 2. Answer the question following Module #2 • Step 3. Complete further modules or take a break.

  3. Module #2 Learning Objectives • Explain the diagnostic features and staging of COPD • Describe non-pharmacologic and the ‘stepped’ pharmacologic therapy for COPD • List Medicare criteria for chronic O2 therapy • Describe steps for assisting patients with smoking cessation

  4. COPD: Prevalence and Cost • 15 million persons in the US • 4th leading cause of death • Cost: $15 billion/year

  5. COPD: Definition • A spectrum of chronic respiratory diseases with: • Airflow limitation • Cough • Dyspnea • Frequent pulmonary infection • Impaired gas exchange • Sputum production

  6. COPD: Diagnosis • Obtain complete PFTs • Allows staging of severity • Assesses oxygen

  7. C OPD P F T s From Images.MD

  8. COPD: Nonpharmacologic Therapy • Smoking cessation • Rehabilitation • Oxygen therapy

  9. COPD: Nonpharmacologic Therapy Smoking cessation • Ask • Advise • Assess willingness • Assist with plan

  10. Pulmonary Rehabilitation Appropriate at all stages of COPD Dyspnea is a good guide to intensity Programs need to be ongoing Goal is 20-30 minutes of sustained activity COPD: Nonpharmacologic Therapy

  11. COPD: Oxygen Therapy

  12. Pharmacotherapy: primary

  13. Pharmacotherapy: other

  14. *bronchodilators= ß-2 agonist , anticholinergics, SR-theophylline

  15. Definition= increased breathlessness, wheezing, cough, sputum Evaluation= Chest X-Ray, EKG, ABG Titrate O2 sat to 90% and recheck ABG COPD Exacerbation

  16. COPD Exacerbation: Therapy • Increase dose or frequency of bronchodilators • Consider IV theophylline • Add steroid • Add antibiotic if ↑sputum volume or purulence

  17. Severe COPD Exacerbation • IF 2 or more of the following: • Severe dyspnea • RR ≥ 25 • pCO2 45-60 • THEN NPPV reduces: • Risk of ventilation • In hospital mortality • Length of stay Images.MD

  18. Images.MD

  19. References • Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev 2002 1: 31 • www.clinicalevidence.com, Chronic Obstructive Pulmonary Disease. • Keenan SP, Sinuff T, Cook DJ , Hill NS , Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature. Ann Intern Med 2003;138: 861 – 870 • Reuben DB, Herr KA, Pacala JT, Pollock BG, Potter JF, Semla TP, eds. Geriatrics at Your Fingertips, 7th Edition, American Geriatrics Society, New York, NY, 2005. Respiratory Diseases pp167-176 • Geriatric Review Syllabus: a core curriculum in geriatric medicine. Fifth Edition 2002-2004. E. L. Cobbs, E.H. Duthie, J.B. Murphy (Eds). • Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease, Global Initiative for Chronic Obstructive Lung Disease (GOLD) . NHLBI/WHO Workshop Report, Executive Summary. National Institutes of Health, National Heart, Lung and Blood Institute. March 2001. NIH Publication No. 2701A. http://www.goldcopd.com.

More Related