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Copd And The Gold Guidelines 02 21 2005[2]

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COPD and the GOLD Guidelines Fiona R. Prabhu, MD Assistant Professor, Family & Community Medicine February 21, 2005
Prevalence ,[object Object],[object Object]
Mortality ,[object Object],[object Object],[object Object]
Costs ,[object Object],[object Object],[object Object],[object Object],[object Object]
Definition ,[object Object],[object Object],[object Object]
Pathogenesis ,[object Object],[object Object],[object Object],[object Object]
Chronic Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pathology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathology ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis of COPD
History of Present Illness ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostic Tests ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spirometry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spirometry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spirometry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Arterial Blood Gas (ABG) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Tests ,[object Object],[object Object],[object Object]
Differential Diagnosis of COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COPD Management Program GOLD (Global Initiative for Chronic Obstructive Lung Disease) Guidelines
Goals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Components ,[object Object],[object Object],[object Object],[object Object]
Assess and Monitor Disease
Initial Visit ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Testing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Follow-Up Visits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Follow-up Visits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Reduce Risk Factors
Risk Factors ,[object Object],[object Object],[object Object]
Smoking Cessation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Treating Tobacco Use and Dependence . Quick Reference Guide for Clinicians.
Smoking Cessation Strategy Treating Tobacco Use and Dependence . Quick Reference Guide for Clinicians. Schedule a follow-up contact, either in person or via telephone Arrange Aid the patient in quitting e.g. quit plan, counseling, intra-treatment social support, extra-treatment social support, approved pharmacotherapy, supplementary materials Assist Determine willingness to make a quit attempt. e.g. within the next 3 days, how willing is this person to make a quit attempt Assess Strongly urge all tobacco users to quit, in a clear, strong, and personalized manner Advise Systematically identify all tobacco users at every visit Ask
Smoking Prevention – What you can do as a provider: ,[object Object],[object Object],[object Object],Treating Tobacco Use and Dependence . Quick Reference Guide for Clinicians.
Occupational Exposures ,[object Object],[object Object],[object Object],[object Object]
Indoor and Outdoor Air Pollution ,[object Object],[object Object],[object Object]
Manage Stable COPD
General Principles ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
COPD Severity ,[object Object],[object Object],[object Object],[object Object],IV Very severe Normal spirometry Chronic symptoms (cough, sputum) 0: At Risk 30%<= FEV 1 < 50% predicted ↑ dyspnea; repeated exacerbations which have an impact on patients’ quality of life III: Severe 50% <= FEV 1 < 80% predicted Progression of symptoms; dyspnea on exertion II: Moderate FEV 1 /FVC < 70% FEV 1 >= 80% predicted Usu. Chronic cough and sputum production I: Mild Characteristics Stage
Patient Education ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bronchodilators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bronchodilators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Glucocorticosteroids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Inhaled Glucocorticoids ,[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Immunizations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Medications? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Other Medications? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Other Medications? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Stage 0: At Risk ,[object Object],[object Object]
Stage I: Mild COPD ,[object Object],[object Object],[object Object],FEV 1 /FVC < 70% FEV 1 >= 80% predicted Usu. Chronic cough and sputum production I: Mild
Stage II: Moderate COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],50% <= FEV 1 < 80% predicted Progression of symptoms; dyspnea on exertion II: Moderate
Stage III: Severe COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],30%<= FEV 1 < 50% predicted ↑ dyspnea; repeated exacerbations which have an impact on patients’ quality of life III: Severe
Stage IV: Very Severe COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],IV Very severe
Non-Pharmacologic Therapy
Rehabilitation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Oxygen Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Surgical Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Surgical Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
COPD Patients and Surgery ,[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Manage Exacerbations
General Points ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Diagnosis and Assessment of Severity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment of Severity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Indications for Hospital Admission ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indications for ICU Admission ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Exacerbations ,[object Object],[object Object],[object Object],[object Object]
Severe Exacerbation, Non Life Threatening ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of COPD Exacerbations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Management of COPD Exacerbations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Management of COPD Exacerbations ,[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
Management of COPD Exacerbations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention
NIPPV ,[object Object],[object Object],[object Object],[object Object]
NIPPV (C-PAP, Bi-PAP) ,[object Object],[object Object],[object Object],[object Object]
NIPPV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indications for Invasive Mechanical Ventilation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Use of Invasive Ventilation in End-Stage COPD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Weaning from Ventilator ,[object Object],[object Object],[object Object]
Discharge Criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Follow-Up Assessment after Hospital Discharge ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
REFERENCES ,[object Object],[object Object],[object Object],[object Object]

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Copd And The Gold Guidelines 02 21 2005[2]

  • 1. COPD and the GOLD Guidelines Fiona R. Prabhu, MD Assistant Professor, Family & Community Medicine February 21, 2005
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  • 23. COPD Management Program GOLD (Global Initiative for Chronic Obstructive Lung Disease) Guidelines
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  • 34. Smoking Cessation Strategy Treating Tobacco Use and Dependence . Quick Reference Guide for Clinicians. Schedule a follow-up contact, either in person or via telephone Arrange Aid the patient in quitting e.g. quit plan, counseling, intra-treatment social support, extra-treatment social support, approved pharmacotherapy, supplementary materials Assist Determine willingness to make a quit attempt. e.g. within the next 3 days, how willing is this person to make a quit attempt Assess Strongly urge all tobacco users to quit, in a clear, strong, and personalized manner Advise Systematically identify all tobacco users at every visit Ask
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