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COPD

Everything you need to know about COPD

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COPD

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  1. COPD Chronic obstructive pulmonary disease

  2. Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.

  3. Plan • 1. Introduction: relevance, purpose; • 2. Main part: definition, etiology, pathobiology, pathology, diagnosis, stages, management, pharmacologic and non- pharmaclogic treatment; • 3. Conclusions, questions and references.

  4. COPD Etiology, Pathobiology & Pathology

  5. Factors that influence disease progression:

  6. Diagnosis and Initial Assessment • COPD should be considered in any patient who has dyspnea, chronic cough or sputum production, and/or a history of exposure to risk factors for the disease. • Spirometry is required to make the diagnosis; the presence of a post-bronchodilator FEV1/FVC < 0.70 confirms the presence of persistent airflow limitation. • The goals of COPD assessment are to determine the level of airflow limitation, the impact of disease on the patient’s health status, and the risk of future events (such as exacerbations, hospital admissions, or death), in order to guide therapy. • Concomitant chronic diseases occur frequently in COPD patients, including cardiovascular disease, skeletal muscle dysfunction, metabolic syndrome, osteoporosis, depression, anxiety, and lung cancer. These comorbidities should be actively sought and treated appropriately when present as they can influence mortality and hospitalizations independently.

  7. Diagnosis

  8. Diagnosis

  9. Choice of thresholds • COPD Assessment Test (CAT TM ) • Chronic Respiratory Questionnaire (CCQ® ) • St George’s Respiratory Questionnaire (SGRQ) • Chronic Respiratory Questionnaire (CRQ) • Modified Medical Research Council (mMRC) questionnaire

  10. ABCD Assessment Tool

  11. Management of Stable COPD • The management strategy for stable COPD should be predominantly based on the individualized assessment of symptoms and future risk of exacerbations. • All individuals who smoke should be strongly encouraged and supported to quit. • The main treatment goals are reduction of symptoms and future risk of exacerbations. • Management strategies are not limited to pharmacologic treatments, and should be complemented by appropriate non-pharmacologic interventions.

  12. Treatment of COPD

  13. Treatment of Stable COPD © 2017 Global Initiative for Chronic Obstructive Lung Disease

  14. Non-Pharmacologic Treatment

  15. Conclusions(Some statistics) • The National Heart, Lung, and Blood Institute (NHLBI) estimates that 12 million adults have COPD, and another 12 million are undiagnosed or developing COPD • Estimated that over 210 million people worldwide have COPD • COPD cost the U.S. economy about $32.1 billion, in direct and indirect costs in 2002 • A person with COPD dies every five minutes in the world • COPD will be the third leading cause of death in the world by 2030

  16. Questions 2. In GOLD’s refined assessment criteria, what is required for a diagnosis of COPD? A. Spirometry B. Lung diffusion capacity test C. Chest x-ray or chest CT scan D. Arterial blood gas test 1. GOLD’supdateddefinitionfor COPD emphasizeswhichdevelopmentalfactors? • A. Respiratorysymptoms • B. Emphysemaandchronicbronchitis • C. Lungtissueandairwayabnormalities • D. A, B, andC • E. AandCbutnotB

  17. 4. In GOLD’s updated guideline, traditional COPD “ABCD” disease severity groups are further defined by the addition of: A. Respiratory symptoms subgroups B. Exacerbation history subgroups C. Spirometric grade subgroups D. Smoking cessation success rates 3. Treatmentofstable COPD isnowbasedondiseaseimpact (symptomburden, activitylimitations) andriskofprogressionasdeterminedbyexacerbations. Trueorfalse? • A. True • B. False

  18. References • The World Health Organization http://www.who.int/mediacentre/factsheets/fs315/en/ • The COPD Foundation http://www.copdfoundation.org/ • The US Department of Health and Human Services http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html • National Heart Lung and Blood Institute http://www.nhlbi.nih.gov/health/public/lung/other/copd_breathe.htm • Center for Disease Control and Prevention http://www.cdc.gov/

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