COPD Review Feb. 26, 2014 Cathy Vakil
Key messages 1) Suspect COPD - prolonged or recurrent cough, dyspnea, or decreased exercise tolerance, smoking history 2) PFTs for confirmation and to document disease progression 3) Encourage smoking cessation 4) Vaccinations
5) Meds 6) Referral – respirologist, pulm. rehab. 7) Rule out co-morbidities (e.g. MI, congestive heart failure, systemic infections, anemia). 8) If end-stage COPD, discuss, document, and periodically re-evaluate wishes about aggressive treatment interventions.
COPD • Treatable • Preventable • Underdiagnosed
Family Physicians’ role • Early detection through targeted screening and prevention by smoking cessation counselling • Optimize symptom control through appropriate pharmacological and non-pharmacological therapy • Prevention and management of acute exacerbations
Causes of COPD • Smoking • Second-hand smoke • Air pollution • Occupational - mine dust (coal, gold), cotton dust, silica and grain dust, cadmium, agriculture • Alpha 1-antritrypsin deficiency
ASTHMA • Canadian Thoracic Society Asthma Management Continuum – 2010 Consensus Summary for children 6 yr and over, and adults • Canadian Pediatric Asthma Consensus Guidelines 2010 update (from 2003) – under 6 yr