Provide a description of the disease that will be treated by your algorithm
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) NR667: Bridget Aliff
COPD should be considered in any patient with chronic cough, sputum production, and dyspnea (GOLD, 2019). Spirometry is required for diagnosis as it is the most objective measurement of airflow limitation, a FEV1/FVC <70 post-bronchodilator confirms diagnosis (GOLD, 2019).Provide a description of the disease that will be treated by your algorithm
CRITERIA FOR DIAGNOSIS
-Spirometry classification of airflow limitation severity
-Modified MRC dyspnea scale -CAT assessment
-The refined ABCD assessment tool (GOLD, 2019)
-Smoking cessation including electronic cigarettes
-Supplemental oxygen (Lopez et al., 2020)
-Both the Flu and pneumonia vaccinations are recommended (Gold, 2019)
NON- PHARMOCOLOGICAL TREATMENT
COPD is a progressive condition that causes pathological changes to the airways (Hollier, 2018). The condition is due to an exaggerated inflammatory process that is caused by irritants or pollutants and the inflammatory process causes remodeling of the tissue which overtime worsens symptoms (Hollier, 2018).Provide a description of the disease that will be treated by your algorithm
WHAT IS COPD?
PHARMACOLOGIC TREATMENT The goal of treatment of COPD is to reduce the
severity of symptoms, reduce the frequency of
exacerbations, and improve exercise tolerance.
There fore treatment plans are individualizedProvide a description of the disease that will be treated by your algorithm
Oral glucocorticoids are reserved for the treatment of acute exacerbations due to the systemic effects if used long-term (GOLD, 2019).
-The use of continuous prophylactic daily antibiotics in patients with frequent exacerbations has been shown to reduce the incidence of exacerbations (GOLD, 2019)
Regular treatment with mucoltytics has been shown to reduce exacerbations in patients not receiving ICS (GOLD, 2019)
MUCOLYTIC & ANTIOXIDANT AGENTS
-Bronchodilators are given on a regular basis to patients with COPD to help reduce symptoms and improve airflow (GOLD, 2019)
-Both Short-acting bronchodilator (SABA) and Long-acting (LABA) are used in the daily management of patients
-They are also sometimes used in combination drugs with anticholinergic (SABA/SAMA) or (LABA/LAMA), or in a triple combination with the addition of ICS (LABA/LAMA/ICS)
-Alpha 1 antitrypsin augmentation therapy -Antitussives -Vasodilators (GOLD, 2019)
OTHER PHARMOCOLOGIC THERAPY
PHARMACOLOGIC TREATMENT ALGORITHM
-Barriers most often include failed smoking cessation, noncompliance with medications, and comorbidities (Barros, 2020)
-Inhalers are often not used correctly and proper use should be assessed to ensure medication administration (Gold, 2019).
-Sometimes patients have adverse reactions to medications or do not believe they need them if they have no symptoms (Barros, 2020)
BARRIERS TO PRACTICE AND OTHER CONSIDERTAIONS:
Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2019)
MOST RECENT GUIDLEINES
-Routine follow up is necessary as lung function can change over time (GOLD, 2019)
-There is no cure, only symptom management (Lopez, 2020)
-Treatment should be adjusted according to lung function and symptoms (Gold, 2019)
Barros, R., Araújo, P., Mourato, C., Budzac, K.,
Oliveira, A. S., & Bárbara, C. (2020). Bronchodilator
reversibility: What are the differences between
asthma and chronic obstructive pulmonary disease?
Eurasian Journal of Pulmonology, 22(3), 169.
GOLD. (2019). Global strategy for the diagnosis,
management, and prevention of COPD. Retrieved
Hollier, A. (2018). Clinical Guidelines in Primary
Care (3rd ed). Advanced Practice Education
López, C., Mascarós, E., Azpeitia, A., & Villarrubia, E. (2020). A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice. International Journal of Chronic Obstructive Pulmonary Disease, Volume 15, 3347–3355. https://doi.org/10.2147/copd.s281422