Everything you need to know about Chronicle obstructive pulmonary disease

1. COPD
CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2. Chronic Obstructive Pulmonary Disease (COPD) is a common,
preventable and treatable disease that is characterized by
persistent respiratory symptoms and airflow limitation that is
due to airway and/or alveolar abnormalities usually caused by
significant exposure to noxious particles or gases.

3. Plan
1. Introduction: relevance, purpose;
2. Main part: definition, etiology, pathobiology, pathology, diagnosis,
stages, management, pharmacologic and non- pharmaclogic
treatment;
3. Conclusions, questions and references.

4. COPD Etiology, Pathobiology & Pathology

5. Factors that influence disease
progression:

6. Diagnosis and Initial
Assessment
► COPD should be considered in any patient who has dyspnea, chronic cough or sputum production,
and/or a history of exposure to risk factors for the disease.
► Spirometry is required to make the diagnosis; the presence of a post-bronchodilator FEV1/FVC < 0.70
confirms the presence of persistent airflow limitation.
► The goals of COPD assessment are to determine the level of airflow limitation, the impact of disease on
the patient’s health status, and the risk of future events (such as exacerbations, hospital admissions, or
death), in order to guide therapy.
► Concomitant chronic diseases occur frequently in COPD patients, including cardiovascular disease,
skeletal muscle dysfunction, metabolic syndrome, osteoporosis, depression, anxiety, and lung cancer.
These comorbidities should be actively sought and treated appropriately when present as they can
influence mortality and hospitalizations independently.

7. Diagnosis

8. Diagnosis

9. Choice of thresholds
►COPD Assessment Test (CAT TM )
►Chronic Respiratory Questionnaire
(CCQ® )
►St George’s Respiratory
Questionnaire (SGRQ)
►Chronic Respiratory Questionnaire
(CRQ)
►Modified Medical Research
Council (mMRC) questionnaire

10. ABCD Assessment Tool

11. Management of Stable COPD
►The management strategy for stable COPD should be
predominantly based on the individualized assessment of
symptoms and future risk of exacerbations.
►All individuals who smoke should be strongly encouraged and
supported to quit.
►The main treatment goals are reduction of symptoms and future
risk of exacerbations.
►Management strategies are not limited to pharmacologic
treatments, and should be complemented by appropriate non-
pharmacologic interventions.

12. Treatment of COPD

13. Treatment of Stable COPD
© 2017 Global Initiative for Chronic Obstructive Lung Disease

14. Non-Pharmacologic Treatment

15. Conclusions
(Some statistics)
•The National Heart, Lung, and Blood Institute (NHLBI) estimates that 12 million
adults have COPD, and another 12 million are undiagnosed or developing COPD
•Estimated that over 210 million people worldwide have COPD
•COPD cost the U.S. economy about $32.1 billion, in direct and indirect costs in
2002
•A person with COPD dies every five minutes in the world
•COPD will be the third leading cause of death in the world by 2030

16. Questions
1. GOLD’s updated definition for
COPD emphasizes which
developmental factors?
A. Respiratory symptoms
B. Emphysema and chronic bronchitis
C. Lung tissue and airway
abnormalities
D. A, B, and C
E. A and C but not B
2. In GOLD’s refined
assessment criteria, what is
required for a diagnosis of
COPD?
A. Spirometry
B. Lung diffusion capacity test
C. Chest x-ray or chest CT scan
D. Arterial blood gas test

17. 3. Treatment of stable
COPD is now based on
disease impact (symptom
burden, activity
limitations) and risk of
progression as
determined by
exacerbations. True or
false?
A. True
B. False
4. In GOLD’s updated
guideline, traditional COPD
“ABCD” disease severity
groups are further defined
by the addition of:
A. Respiratory symptoms
subgroups
B. Exacerbation history
subgroups
C. Spirometric grade
subgroups
D. Smoking cessation success
rates

18. References
•The World Health Organization
http://www.who.int/mediacentre/factsheets/fs315/en/
•The COPD Foundation
http://www.copdfoundation.org/
•The US Department of Health and Human Services
http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html
•National Heart Lung and Blood Institute
http://www.nhlbi.nih.gov/health/public/lung/other/copd_breathe.htm
•Center for Disease Control and Prevention
http://www.cdc.gov/