peter90036
Forum Elite
Topics: 28
Posts: 315
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trying to understand COPD treatment (reading from Kaplan+FA)
Maintenance treatment for COPD
- Anticholinergics (ipratropium) inhaled
- B2 agonists (albuterol) inhaled - added to #1 if not enough or all the time?
- teophylline i think this is when 1,2 not enough?
- Oxygen if PaO2 <55 or sat <85 / or PaO2>55 if has cor pulmonale/RVF ... is oxygen continuous or just at night?
COPD acute exacerbation
- Oxygen to maintain PaO2>60 sat90% ... if PaO2 already >60 do still plug in O2?
- Antibiotics ... says empirically .. ?! .. just when signs of infection right ???
- Corticosteroids... it says FIRST LINE ...?
- FA adds Ipratropium ...
in exacerbation which to give 1st: CS , ipratropium or albuterol ???
Edited by peter90036 on 03/31/08 - 07:15 PM
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| liliaeliz
Forum Elite
Topics: 38
Posts: 346
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cs
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| aspire
Forum Senior
Topics: 24
Posts: 158
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Acute exacerbation:
1st- inhaled B2 agonists or inhaled anticholinergics ( if combination is given as a choice, then that one)
no response--> repeat administration--> still no response--> systemic (iv) theophyllline or aminophylline.
also give, short course of steroids and antibiotics.
Oxygen:
1.Pa02 < 55 mm of Hg or Sa02<88%
2.Pa02=56-59 mm of Hg or Sa02>89% with right hear failure or pulmonary hypertension or polycythemia( Hct > 55%).
source: washington manual
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