COPD is a chronic lung disease characterized by airflow obstruction and breathing difficulties. It typically worsens over time and is caused primarily by smoking or air pollution exposure. Key symptoms include shortness of breath, chronic cough, and sputum production. Management involves preventing exposure to risk factors through smoking cessation, exercise, and medications like inhaled bronchodilators and steroids. During acute exacerbations, treatment may include increased bronchodilators, antibiotics, oral steroids, and supplemental oxygen.

1. COPD
A Crash Course
with Dr Cal Pierce

2. Our Agenda

3. What is COPD?
Our Agenda

4. What is COPD?
Why should I care?
Our Agenda

5. What is COPD?
Why should I care?
What are the risk factors?
Our Agenda

6. What is COPD?
Why should I care?
What are the risk factors?
What can I do about it?
Our Agenda

7. What is COPD?

8. Attacks those in
middle age and
older

9. characterised by attacks
of chronically
poor airflow…

10. It typically gets
progressively
worse over time….

11. irreversible

12. Chronic obstructive pulmonary
disease (COPD) is a lung disease characterized
by chronic obstruction of lung airflow that
interferes with normal breathing and is not
fully reversible.

13. What is COPD?
A Three Part Process
Chronic
Disabling
ALWAYS gets worse

14. What is COPD?

15. Part 1: Inflammation
Can affect any person at any age
Related to the lung
Life threatening

16. What is COPD?

17. Part 2: Emphysema

18. Part 2: Emphysema

20. What is COPD?

21. COPD Consequences
what comes
beforean
exacerbation?

22. Chronic vs Acute
patient will
always have
symptoms

23. Chronic vs Acute
develop
over years

24. Chronic vs Acute
decreasing
quality of
life

25. Chronic vs Acute
history
diagnosis is based on?

26. Let’s take a look at the chronic
background

27. Chronic
Three key symptoms…
1. Shortness of breath
2. Sputum
3. Chronic cough

28. Shortness of Breath
1. Classification
2. Quality of Life

29. Classification
moderate severe
normal
activity
at rest

30. Chronic
Three key symptoms…
1. Shortness of breath
2. Sputum
3. Chronic cough

31. Chronic Cough + Sputum
“at least three months a year
for two years”

32. Chronic Cough + Sputum
purulent

33. Chronic
Three key symptoms…
1. Shortness of breath
2. Sputum
3. Chronic cough

34. What about the
acute…?

35. Hypersensitivity
there can be no
exacerbation without
hypersensitivity!

36. Hypersensitivity
Can affect any person at any age
Related to the lung
Life threatening

37. Hypersensitivity
normal COPD

38. But what do we
mean by
‘exacerbation’?

39. What is an exacerbation?
1. INCREASED Shortness of breath
2. INCREASED Sputum
3. INCREASED Cough

40. What causes an exacerbation?

41. 80%

43. How do I tell the difference?
Age
Cough
Smoker?
COPD
Over 40
Always
Always
Asthma
Under 40
Variable
Variable

44. What is COPD?
Why should I care?
What are the risk factors?
What can I do about it?
Our Agenda

45. Why should I care?

46. Preventable!
Treatable!
It kills!
Why should I care?

47. DevelopingDeveloped
10% 90%

48. 1990 2020
Ischaemic heart disease
Cerebrovascular disease
Lower resp infection
Diarrhoeal disease
Perinatal disorders
COPD
Tuberculosis
Measles
Road Traffic Accidents
Lung Cancer

49. 30%
of
smokers

50. Heart Attack
Diabetes
Depression
Why should I care?

51. why does it
occur?

52. genes?
environment?

53. 90%
environmental

54. what is the
main culprit?

55. Smoking

56. Air Pollutants

57. Air Pollutants

58. So…
what does COPD
look like?

59. 1. Smoker
2. Middle age or older
3. Productive cough & breathless
4. Exacerbations

60. What is COPD?
Why should I care?
What are the risk factors?
What can I do about it?
Our Agenda

61. What can I do about it?

62. Two strategies…
Prevent
Manage

63. Prevention

64. Prevention

65. Prevention
Cut out the smoke.
Avoid exposure to air pollution

66. Two strategies…
Prevent
Manage

67. What is the main component of
management?

68. Management: Chronic

69. Management: Chronic
exercise

70. Management: Chronic
What percent of COPD
patients will benefit from
exercise?

71. Management: Chronic
Every
single
patient…!

72. Management: Chronic

73. Management: Chronic
1. Stop smoking
2. Reduce exposure
3. Exercise
4. Medications

74. Medications
(according to WHO…)
1. Inhaled Salbutamol
2. Oral Theophylline
3. Inhaled Steroids

75. Medications
Which medications will
change the long-term
decline?

77. Management: Chronic
1. Stop smoking
2. Reduce exposure
3. Exercise
4. Medications

78. Management: Acute
Do they
need EPR?

79. Management: Acute
Chest pain
Struggling for breath
Not struggling at all
Drowsiness or confusion
Fever
Hypotension

80. Management: Acute
Do they need EPR?
How can I treat this exacerbation?

81. How can I treat an exacerbation?

83. How can I treat an exacerbation?
1. Inhaled Salbutamol
2. Antibiotics
3. Oral Steroids
4. Oxygen

84. Take Home Messages
1. Chronic cough
2. Productive
3. Breathless
4. Prevention better than cure