Chronic Obstructive Pulmonary Disease Lab

3/26/25, 3:56 AM OneNote COPD Wednesday, March 12, 2025 9:06 PM Topic Discussion: Chronic Obstructive Pulmonary Disease (COPD) (10 minutes) 1. Background/Introduction a. Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease characterized by persistent airflow limitation. It is most commonly caused by smoking and long-term exposure to pollutants. b. Epidemiology: COPD is the third leading cause of death globally, particularly those over the age of 40. c. Different types/classifications of the disease: COPD is generally classified by severity using spirometry (FEV1/FVC ratio), with stages ranging from mild (stage 1) to very severe (stage 4). d. Risk Factors: (3 for full points) Smoking, environmental pollutants, occupational exposures, and genetic factors like alpha-1 antitrypsin deficiency. 2. Pathophysiology/Etiology Chronic exposure to irritants causes inflammation, leading to narrowing of the airways, mucus production, and destruction of alveolar walls, resulting in airflow limitation. 3. Signs and Symptoms a. Pertinent Labs: Spirometry (FEV1/FVC ratio < 0.70) confirms diagnosis. Arterial blood gases may be used in severe cases. b. Presenting Symptoms: (3 for full points) Chronic cough, shortness of breath, wheezing, and chest tightness, particularly with physical activity. c. Assessment/diagnostic criteria/tools: Spirometry, chest X-ray, CT scan, and ABG if necessary 4. Treatment a. Approach to Therapy i. Non-pharmacological (2 for full points) • Smoking cessation: The most effective intervention for slowing disease progression. • Pulmonary rehabilitation: Exercise programs and breathing techniques. • Oxygen therapy: For patients with severe hypoxemia. https://americancareercollege-my.sharepoint.com/personal/cvo1_u_westcoastuniversity_edu/_layouts/15/Doc.aspx?sourcedoc={5ba16cd8-9933-4504-ade5-0b389535a42c}&action=view&wd=target%28Topic Presentation.… 1/2 3/26/25, 3:56 AM OneNote ii. Pharmacological (full points: unique clinical pearl for ALL 1st line medication classes/agents) 1. 1st line agents: a. Bronchodilators: Beta-agonists (e.g., albuterol) and anticholinergics (e.g., tiotropium) i. Bronchodilators improve airflow, while inhaled corticosteroids reduce inflammation ii. Beta-agonists: Can cause tachycardia and tremors. b. Inhaled corticosteroids: budesonide, fluticasone i. Used in combination for more severe symptoms. ii. Risk of oral candidiasis; patient should rinse mouth after use. 2. 2nd line agents: a. Phosphodiesterase-4 inhibitors (e.g., roflumilast) for severe COPD. i. Phosphodiesterase inhibitors help reduce exacerbations in severe cases. b. Duration of therapy: Ongoing management with bronchodilators and corticosteroids to control symptoms. 5. Possible Questions from Evaluators (5 minutes) • Drug Questions: • Brand/Generic: Albuterol (Ventolin), tiotropium (Spiriva), roflumilast (Daliresp). • Counseling Points: Instruct on proper inhaler technique. • Monitoring: Assess symptom control and exacerbation frequency. • Contraindications: Caution with cardiovascular disease (due to beta-agonist effects). • MOA: Beta-agonists relax bronchial smooth muscle, and corticosteroids reduce airway inflammation. Guideline: Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 Report https://americancareercollege-my.sharepoint.com/personal/cvo1_u_westcoastuniversity_edu/_layouts/15/Doc.aspx?sourcedoc={5ba16cd8-9933-4504-ade5-0b389535a42c}&action=view&wd=target%28Topic Presentation.… 2/2