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CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Chronic obstructive pulmonary disease (COPD) is an inflammatory respiratory disease characterized by reversible airflow limitation.

The patient usually have chronic cough, sputum production or dyspnea with or without history of risk factors for the disease.

The chronic airflow limitation is caused by a combination of small airways disease and parenchymal destruction.

It is a preventable & treatable disease.

Monitoring

Prior to discharge from the hospital, check the patient based on the following criteria:

  • Able to use long-acting either beta2-agonists &/or anticholinergics with or without inhaled corticosteroids
  • Inhaled beta2-agonist is needed every 4 hours or less frequently
  • Able to walk across the room (if previously ambulatory)
  • Able to eat & sleep without frequent interruptions due to breathing difficulty
  • Clinically stable for 12-24 hours
  • ABG stable for 12-24 hours
  • Patient & caregiver adequately understand correct medication use
  • Home care arrangements (eg O2 delivery) are in place
  • Patient, family & physician are confident that patient can manage well

Follow Up

  • A follow-up assessment must be carried out within 4-6 weeks following discharge from hospital for exacerbations
  • Check patient’s ability to cope in his environment
  • Measure FEV1
  • Check inhaler technique
  • Check understanding & ability to follow treatment regimen
  • Assess need for long-term O2 therapy &/or home nebulizer for patients with very severe COPD
  • Check status of comorbidities
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