COPD
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
- Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.
Signs and Symptoms
- Shortness of breath, especially during physical activities
- Wheezing
- Chest tightness
- A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish
- Frequent respiratory infections
- Lack of energy
- Unintended weight loss (in later stages)
- Swelling in ankles, feet or legs
Investigations
- CBC to look for polycythemia
- Differential count, CRP, ESR
- Chest X-ray
- ECG
- C/S
- Arterial blood gas to decide about LTOT
Management
- General measures include Cessation of smoking
- Suction Oxygen inhalation (24%) by venturi mask Stat/SOS
- Tab Augmentin (Amoxicillin+ Clavulanic acid) 625mg 1 tab PO x TD
- Inf Mofest/Xefecta (moxifloxacin) 400mg IV x OD 'OR'Tab- Mofest/ Xefecta 400mg 1 tab PO x OD. I
- If not improving change antibiotic based on sputum culture result, where known.
- Atem ipratropium Br) nebulization or 2-4 puffs TDs
- Clenil (Beclomethasone) nebulization (2cc + 5cc N/S) P/N BD or TDS
- Tab Deltacortel (prednisone) 5mg, 2 tab PO X QID for 5 days.
- If the patient cannot tolerate oral therapy, then go for
- Inj-Hyzonate (hydrocortisone) 250 mg IV x stat 100mg IV x TDS
- Inj Lasix (Furosemide) 20 mg IV x stat if there is pulmonary edema
- Physiotherapy in selected cases.
- Arrange prophylactic influenza vaccine.