COPD Vs Asthma AE - Management of acute exacerbations of...

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Unformatted text preview: Management of acute exacerbations of COPD and Asthma similarities and differences Importance Imp cause of morbidity and mortality Accelerated decline in lung function Poorer quality of life Increased medical costs Incidence Ranges from 1-4% About 10% - requires ICU admission 2% of all admitted patients intubation PGI data in last 5 mths Total pts. In EMOPD 6254 Acute exacerbation of COPD 111 (1.8%) Acute exacerbation of asthma 66 (1.1%) Ann Allergy Asthma Immunol,2004 Definition Sustained worsening of patients symptoms From normal stable state Beyond normal day to day variations Acute onset Often necessitates change in medication Chest 2000;117:398S-401S COPD and Asthma Asthma COPD sensitizing agent noxious agent airway inflammation airway inflammation CD4+ T iympho CD8+ T lympho eosinophils macrophages, neutrophils reversible irreversible Airflow limitation The Dutch Hypothesis Asthma Intermittent airflow obstruction Improvement with bronchodilators and steroids High level of bronchial responsiveness Broad inflammatory mediator responses Airway remodeling (epithelial injury and fibrosis) COPD Progressive airflow obstruction Smaller bronchodilator and steroid response Most have increased bronchial responsiveness Cytokine, chemokine, proteases responses Emphysema (lung destruction) frequent EMOPD Diagnosis & estimation of severity Brief focused clinical history : severity of symptoms, all medications, cause of exacerbation, high risk factors esp....
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This note was uploaded on 12/03/2011 for the course MEDICINE 350 taught by Professor Dr.aslam during the Winter '07 term at Medical College.

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COPD Vs Asthma AE - Management of acute exacerbations of...

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