COPD: Difference between revisions
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# | ==Definition== | ||
Airflow obstruction as measured by spirometry isdefined as a ratio of the postbronchodilator FEV1 : FVC < 0.70 | |||
==Exacerbation== | |||
#Albuterol | |||
#Atrovent | |||
#Steroids: Prednisone 40mg po qday x 5-10d | |||
#Abx | |||
#*Levaquin (sick) | |||
#*Doxy (outpt) sputum change | |||
#CXR | |||
#BiPap/Intubation | |||
#Carefull with O2 & hypoxic drive | |||
==Maintenance== | |||
#B-agonist | |||
#*Short: albuterol 90µg/inh 1-2 q4-6h prn; neb 2.5mg q4-6h prn | |||
#*Long: Salmeterol 50µg/inh 1 bid | |||
#*Formoterol MDI 12µg/INH 1 bid; neb 20µg bid | |||
#*Arfomoterol neb 15µg bid | |||
#Anticholinergic | |||
#*Short: ipratriopium 17µg/INH 2xINH 4x/d up to 12; neb 0.5mg q6-8h | |||
#*Long: tiotropium 18µg/INH 1xINH qam | |||
#Steroids (inhaled) | |||
#*Fluticasone (dry powder) 250µg/INH 1-2 bid; (aerosol) 220µg 1-2INH bid | |||
#*Budesonide 160µk 2 inh bid | |||
#*Beclomethasone 80µg/inh 2INH bid | |||
#*Mometasone 220µg/INH 1-2INH bid | |||
#Combination | |||
#*Albuterol-Ipratropium 90/18 2INH 4xd up to 12 | |||
#*Advair Diskus = Fluticasone-salmeterol (dry powder): 250/50 1INH bid | |||
#*Budesonide-Formoterol: 160/4.5 2INH bid | |||
#Home O2 | |||
#*Indicated if PaO2 < 55mmHg or O2 Sat < 88% RA | |||
Goal is 18h/day including sleep with flow rate that maintain sat > 90% | |||
==Source== | |||
DONALDSON 1/06, NEJM 4/10 | |||
[[Category:Pulm]] | [[Category:Pulm]] | ||
Revision as of 03:03, 25 July 2011
Definition
Airflow obstruction as measured by spirometry isdefined as a ratio of the postbronchodilator FEV1 : FVC < 0.70
Exacerbation
- Albuterol
- Atrovent
- Steroids: Prednisone 40mg po qday x 5-10d
- Abx
- Levaquin (sick)
- Doxy (outpt) sputum change
- CXR
- BiPap/Intubation
- Carefull with O2 & hypoxic drive
Maintenance
- B-agonist
- Short: albuterol 90µg/inh 1-2 q4-6h prn; neb 2.5mg q4-6h prn
- Long: Salmeterol 50µg/inh 1 bid
- Formoterol MDI 12µg/INH 1 bid; neb 20µg bid
- Arfomoterol neb 15µg bid
- Anticholinergic
- Short: ipratriopium 17µg/INH 2xINH 4x/d up to 12; neb 0.5mg q6-8h
- Long: tiotropium 18µg/INH 1xINH qam
- Steroids (inhaled)
- Fluticasone (dry powder) 250µg/INH 1-2 bid; (aerosol) 220µg 1-2INH bid
- Budesonide 160µk 2 inh bid
- Beclomethasone 80µg/inh 2INH bid
- Mometasone 220µg/INH 1-2INH bid
- Combination
- Albuterol-Ipratropium 90/18 2INH 4xd up to 12
- Advair Diskus = Fluticasone-salmeterol (dry powder): 250/50 1INH bid
- Budesonide-Formoterol: 160/4.5 2INH bid
- Home O2
- Indicated if PaO2 < 55mmHg or O2 Sat < 88% RA
Goal is 18h/day including sleep with flow rate that maintain sat > 90%
Source
DONALDSON 1/06, NEJM 4/10