Respiratory Medicine COPD 2024 PDF

Respiratory Medicine Obstructive disease Airway diseases COPD 16/10/2024 Dr. Mahad Sadik Mukhtar Pulmonologist MD Pulmonary medicine MU MBBS A9  LECTURE CONTENTS  CASE SCENARIO INTRODUCTION  EPIDEMIOLOGY ...

Respiratory Medicine Obstructive disease Airway diseases COPD 16/10/2024 Dr. Mahad Sadik Mukhtar Pulmonologist MD Pulmonary medicine MU MBBS A9  LECTURE CONTENTS  CASE SCENARIO INTRODUCTION  EPIDEMIOLOGY  TYPES OF COPD  CAUSES AND RISK FACTORS OF COPD  PATHOPHYSIOLOGY  CLINICAL FEATURES  DIAGNOSIS OF COPD  MANAGEMENT OF COPD  PREVENTIONS OF COPD  CASE SCENARIO  A 66-year-old man with a smoking history of one pack per day for the past 47 years presents with progressive shortness of breath and chronic cough, productive of yellowish sputum, for the past 2 years.  On examination he appears cachectic and in moderate respiratory distress, especially after walking to the examination room, and has pursed-lip breathing. His neck veins are mildly distended.  INTRODUCTION  Chronic obstructive pulmonary disease (COPD) has been described as ‘a disease state characterized by airflow limitation that is not fully reversible.  The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. Remember, as long as you are breathing it’s never too late to start a new beginning.  EPIDEMIOLOGY COPD is more common in older people, especially those aged 65 years and older. COPD prevalence is highest in the World Health Organization region of the Americas and lowest in the South- East Asia and Western Pacific regions. The pooled global prevalence is 15.7% in men and 9.93% in women  EPIDEMIOLOGY Globally, deaths from COPD increased by 23% from 1990 to 2017, and currently there are about 3 million deaths from COPD each year. The expanding epidemic of smoking and ageing of the world population, as well as the reduced mortality from other causes of death such as cardiovascular disease, mean that by 2060 there may be over 5.4 million deaths per year due to COPD and related diseases. COPD RISK FACTORS TYPES OF COPD PATHOPHYSIOLOGY Continue…….. CLINICAL FEATURES Here is a Easy To Remember to help you symptoms of COPD: DIAGNOSIS  INVESTIGATIONS CBC CHEST X-RAY SPIROMETRY HRCT ABG ECG ECHO ALPHA ANTI-TRYPSIN LEVEL  SEVERITY CLASSIFICATION COPD ASSESSMENT  CHEST-XRAY Chest x-ray (CXR) is rarely diagnostic but should be performed to exclude other diagnoses and to assess for the presence of significant comorbidities.  Bronchodilato rs  Beta agonists Shot Acting Beta Agonists(SABA) Long Acting Beta Agonists(LABA)  Muscarenic antagonists Short Acting Muscarinic Antagonists(SAMA) Long Acting Muscarinic Antagonists(LAMA)  Methylxanthines( Aminophylline)  Inhaled CorticoSteroids (ICS)  ICS combined to LABA is more effective than individual components in improving lung function and health status and reducing exacerbation in severe COPD  Increases risk of pneumonia  Blood eosinophils count essential before treatment  Triple inhaled therapy LABA- LAMA-ICS may be useful in selected patients ETR