What are risk factors for COPD? - Smoking (increasing w/number of pack years)
Second hand smoke
Environmental pollution (endotoxins, coal dust, mineral dust)
What is seen on phys exam in COPD? - May be normal in early states
, As severity progresses: lung hyperinflation, decreased breath sounds, wheezes at bases, distant heart
tones (b/c of hyperinflation, so S1/S2 sounds off in distance), accessory muscle use, pursed lip breathing,
increased expiratory phase, neck vein distention.
How is COPD diagnosed? - Spirometry is gold standard (pre and post bronchodilator).
Irreversible airflow limitation is hallmark.
How is COPD treated? - Bronchodilators: beta agonists (long/short), anticholinergics (long/short), or
combo.
What is the MOA of beta agonists? - Stimulates beta-2-adrenergic receptors, increasing cyclic AMP,
resulting in relaxing airways.
What is the MOA of anticholinergics? - Block the effect of acetylcholine on muscarinic type 3 receptors,
resulting in bronchodilation.
Why are long-acting beta agonists prescribed for COPD? - They are for moderate airflow limitation.
They relieve symptoms, increase exercise tolerance, reduce number of exacerbations, improve QOL.
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