Chronic Obstructive Pulmonary Disease: Introduction FeedbackA general introduction to Chronic Obstructive Pulmonary Disease.Source: Clinical Knowledge Summaries
Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction which is usually progressive, not fully reversible, and does not change markedly over several months.
Tobacco smoking is the major risk factor for development of COPD.
There may be disability and impairment of quality of life.
A diagnosis of COPD can be made if the person meets all of the following criteria:
Age older than 35 years.
Presence of a risk factor (for example smoking, history of smoking, or an occupational exposure).
Absence of clinical features of asthma.
Presence of airflow obstruction confirmed by post-bronchodilator spirometry.
Typical symptoms include:
Regular sputum production.
Frequent 'winter bronchitis'.
Other symptoms include weight loss, exercise intolerance, ankle swelling, fatigue, and chest pain or haemoptysis (rare).
Signs include hyperinflated chest, wheeze or quiet breath sounds, pursed lip breathing, use of accessory muscles, peripheral oedema, cyanosis, raised jugular venous pressure, and cachexia.
Post-bronchodilator spirometry should be measured to confirm the diagnosis of COPD.
Spirometry should be carried out 15–20 minutes after inhalation of salbutamol.
In COPD, the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC ratio) is less than 0.7.
Severity should be assessed in terms of:
The degree of airflow obstruction according to the reduction in forced expiratory volume in 1 second (FEV1).
The degree of breathlessness according to the Medical Research Council dyspnoea scale.
Presence of cor pulmonale.
The person's smoking history should be documented and encouragement given regarding stopping.
Anxiety or depression should be screened for in people who are hypoxic or have severe dyspnoea.
The full blood count should be checked, and other investigations arranged as appropriate.
The person should be offered inhaled treatment — strategies for stepping up inhaled treatments differ according to the reduction in FEV1.
Referral should be considered, when appropriate:
To a respiratory specialist, for assessment for oxygen therapy.
For pulmonary rehabilitation.
To a physiotherapist.
To social services and occupational therapy.
An annual influenza vaccination and a once-only pneumococcal vaccination should be advised.
A self-management plan that includes how to recognize the early signs of an exacerbation and respond appropriately should be discussed.
Acute exacerbations should be treated by prescribing:
Systemic corticosteroids for people with a significant increase in breathlessness.
Oral antibiotics for people with a history of more purulent sputum or clinical signs of pneumonia.
Advice should be offered on nutrition, medications, exercise, and flying.
Cor pulmonale should be managed, usually by referring the person to a respiratory specialist.
All people with COPD should be followed up; the frequency of follow up depends on the severity of disease.
End-of-life issues should be discussed when appropriate.
Chronic Obstructive Pulmonary Disease: Guidance FeedbackThe most relevant search results for Chronic Obstructive Pulmonary Disease from producers of guidance information.
- Clinical Knowledge Summaries
Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update) - guidance (CG101)National Institute for Health and Care Excellence, 01 June 2010
- Chronic obstructive pulmonary disease - NICE Pathways
- Finnish Medical Society Duodecim, 22 November 2013
- National Institute for Health and Care Excellence, 08 February 2012
Chronic Obstructive Pulmonary Disease: Commissioning FeedbackThe most relevant search results for Chronic Obstructive Pulmonary Disease from producers of commissioning advice.
- National Institute for Health and Care Excellence, 01 October 2011
- National Institute for Health and Care Excellence, 01 July 2011
Chronic obstructive pulmonary disease - NICE support for commissioners and others using the quality standard (QS10) [PDF]National Institute for Health and Care Excellence, 27 July 2011
Hospital at home for patients with acute exacerbations of Chronic Obstructive Pulmonary Disease [PDF]QIPP, 27 November 2009
- QIPP, 27 November 2009
Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases [PDF]QIPP, 12 December 2011
Information for the public
Chronic Obstructive Pulmonary Disease: Information for the public FeedbackThe most relevant search results for Chronic Obstructive Pulmonary Disease, from Department of Health accredited producers of patient information.
- NHS Choices, 01 October 2014
- Patient UK
- Patient UK
- Patient UK
- NHS Choices, 19 February 2013
- Patient UK
- Patient UK
- Patient UK
- Bupa , 16 July 2014
- NHS Choices, 10 April 2014
Chronic Obstructive Pulmonary Disease: Medicines FeedbackAppropriate medicines information for Chronic Obstructive Pulmonary Disease supplied by Datapharm, a leading source of trusted, credible information about medicines.
Chronic obstructive pulmonary disease - Medicines Information
- Budesonide/Formoterol fumarate dihydrate (a generic version of Symbicort)
- Deltacortril (a brand of Prednisolone)
- Dexamethasone sodium phosphate
- Dexsol (a brand of Dexamethasone Sodium Phosphate)
- Easyhaler Formoterol
- Erdotin (a brand of Erdosteine)
- Fluticasone/Salmeterol (a generic version of Seretide)
- Foradil (a brand of Formoterol Fumarate Dihydrate)
- Formoterol fumarate dihydrate
- Indacaterol maleate
- Ipratropium (a generic version of Respontin)
- Ipratropium/Salbutamol (a generic version of Combivent)
- Mucodyne (a brand of Carbocisteine)
- Phyllocontin (a brand of Aminophylline)
- Roflumilast (a generic version of Daxas)
- Salmeterol (a generic version of Serevent)
- Tiotropium (a generic version of Spiriva)
Chronic Obstructive Pulmonary DiseaseOpen
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...people have chronic obstructive pulmonary disease (COPD) in the...study of chronic obstructive pulmonary disease. London...definition of COPD COPD is...prevention of chronic obstructive pulmonary disease. *Symptoms...diagnose COPD in people...
National Institute for Health and Care Excellence, 01 June 2010
...disease Chronic obstructive pulmonary disease D029424Pulmonary Disease, Chronic Obstructive D029481Bronchitis...D008173Lung Diseases, Obstructive...November 2010 Chronic obstructive pulmonary disease - Summary...tw., Chronic Obstructive pulmonary Disease.tw., exp Lung Diseases, Obstructive...
Clinical Knowledge Summaries
National Institute for Health and Care Excellence, 09 May 2011 - Publication type: Pathway, Guidance
A randomised 2 × 2 trial of community versus hospital pulmonary rehabilitation for chronic obstructive pulmonary disease followed by telephone or conventional follow-up
...intervention for chronic obstructive pulmonary disease patients...capacity in chronic obstructive...prevention of chronic obstructive pulmonary disease: National... 01/15 Pulmonary rehabilitation for chronic obstructive pulmonary disease 01/15...
NIHR Journals Library - Health Technology Assessment, 12 February 2013
A randomised controlled equivalence trial to determine the effectiveness and cost utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX)
...of severe chronic obstructive pulmonary disease. Respir Care...techniques in chronic obstructive pulmonary disease? Chron Respir...management of chronic lung diseases: an overview...outcome of pulmonary rehabilitation...bronchitis and chronic obstructive pulmonary disease: a review...
NIHR Journals Library - Health Technology Assessment, 12 February 2013
...with severe disease defined as...Initiative for Chronic Obstructive Lung Disease (GOLD) Chronic obstructive pulmonary disease; NICE Clinical...Miravitlles M; Chronic obstructive pulmonary disease. Lancet...Feb 6. Chronic obstructive pulmonary disease; NICE CKS...
...Infectious Disease and Therapy...Journal of Chronic Obstructive Pulmonary Disease... Chronic Obstructive Pulmonary Disease and...Keywords Chronic obstructive...Patients with Chronic Obstructive Pulmonary Disease (COPD) Different...Symptomatic chronic obstructive pulmonary disease in clinical...People with Chronic Obstructive Pulmonary Disease More ...
31 May 2012 - Publisher: Informa Healthcare - Publication type: Systematic Reviews
...of Chest Diseases and Allied...dyspnea in chronic obstructive pulmonary disease. Chest 1990...reconditioning in chronic obstructive pulmonary disease. American...in severe chronic obstructive pulmonary disease. European...Respiratory Diseases 1981;62...
Cochrane Database of Systematic Reviews, 18 October 2006 - Publisher: John Wiley & Sons, Ltd
...tolerance in chronic obstructive pulmonary disease. European...Respiratory Diseases 1997;10...patients with chronic obstructive pulmonary disease: a disease...Managing chronic obstructive pulmonary disease in the community...
Cochrane Database of Systematic Reviews, 10 October 2013 - Publisher: John Wiley & Sons, Ltd
Evaluation of the use of inhaled medications by hospital inpatients with chronic obstructive pulmonary disease
...Inpatients with Chronic Obstructive Pulmonary Disease Joshua...prevalence of chronic obstructive pulmonary disease (COPD) is increasing...diagnosis of COPD who were...Keywords chronic obstructive pulmonary disease; inhaler...
01 May 2012 - Publisher: Canadian Journal of Hospital Pharmacy - Publication type: Medicines Management
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