COPD, PF, Asthma Treatment

COPD, PF, Asthma Treatment - Learning Issue: Treatment for...

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Learning Issue: Treatment for COPD, PF, and Asthma-MH COPD Treatment: Avoidance of tobacco use and elimination of air pollutants Supplemental O2, usually through nasal O2 or a face mask to ensure oxygen saturation >90% measured by pulse oximetry. Indications for home O2 Rx are PaO2 < 55 mmHg or O2 sat < 88%. Pharmacologic treatment should be administered in a stepwise approach according to the severity of disease and pt's tolerance for specific drugs. o Bronchodilators improve sx, quality of life, and exercise tolerance and ↓ incidence of exacerbations. o Anticholinergics (e.g., ipratropium inhaler 2 puffs qid) are effective first-line agents. They are available in combination w/albuterol (Combivent). Tiotropium (Spiriva HandiHaler) is a long-acting bronchodilator. It is effective for the long- term, once-a-day maintenance treatment of bronchospasm. o Short-acting β2 agonists (e.g., albuterol MDI 1-2 puffs q4-6h PRN) are acceptable in pts w/mild, variable sx. Long-acting inhaled agents (e.g., salmeterol or formoterol 1-2 puffs bid) are useful in pts w/mild to moderate or continuous sx. o Addition of inhaled steroids (fluticasone, budesonide, triamcinolone) is used to ↓ exacerbations in pts w/moderate to severe COPD. Acute exacerbation of COPD can be treated with o Aerosolized β2 agonists (e.g., metaproterenol nebulizer solution 5% 0.3 mL or albuterol nebulized 5% solution 2.5-5 mg) o Anticholinergic agents, which have equivalent efficacy to inhaled β-adrenergic agonists. Inhalant solution of ipratropium bromide 0.5 mg can be administered q4-8h and in combination with β2 agonists. o
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COPD, PF, Asthma Treatment - Learning Issue: Treatment for...

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