Week 4 Initial Post COPD `COPD (chronic obstructive pulmonary disease is a disease process that is characterized by the chronic progression of airflow limitation. This disease is broken down into two categories, chronic bronchitis, and emphysema. There are many causes of COPD, but the main risk factor is tobacco smoking [Poc18]. However, other risks factors for the development of this disease include exposure to air pollutants, severe respiratory infections as a child, and hereditary alpha – 1 antitrypsin deficiency [Arc17]. Other hereditary factors that increase the risk for the development of COPD are abnormal lung development and accelerated aging [Poc18]. Nonsmokers develop COPD secondary to longterm exposure to noxious gases and air pollutants and genetics. All patients who present with a persistent cough or production of sputum that is chronic in nature, dyspnea, and/or a history of exposure to risk factors should be considered for COPD [Poc18]. COPD can only be diagnosed via the use of spirometry. The diagnosis of COPD is made if the presence of a post-bronchodilator FEV 1 /FVC is less than 0.70. Pharmacologic Therapy for COPD The pharmacologic treatment of COPD is aimed at reducing symptoms, the frequency of severity and exacerbations, and improve exercise and health status of the patient. The GOLD guidelines target drug therapy based on the COPD group: Group A is low risk, less symptoms Group B is low risk, more symptoms Group C is high risk, less symptoms Group D is high risk, more symptoms [Arc17].
Drug Therapy per GOLD 2018 Bronchodilators Most often given on a regular basis to prevent or reduce symptoms Short-acting bronchodilators on a regular basis are not generally recommended [Poc18] Beta 2-agonists Relaxes smooth airway muscles Consists of both SABA and LABA o SABAs are indicated for acute COPD symptoms o LABAS are indicated for chronic maintenance [Arc17] Adverse effects: can produce resting sinus tachycardia and cardiac rhythm disturbances in susceptible patients, exaggerated somatic tremors can be troublesome in older patients when treated with higher doses regardless of route [Poc18] Antimuscarinic Block bronchoconstrictor effects of acetylcholine and M3 muscarinic receptors expressed in airway smooth muscle
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- adverse effects