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COPD - Jindal Chest Clinic
COPD - Jindal Chest Clinic
Goals of treatment
• Symptomatic relief
• Prevention of complications
• Removal of risk-factors
• Treatment of complications & Ac
Exacerbations
• Reduce the rate of decline in lung
function
• Prevent morbidity and mortality
• Rehabilitation of patient
MANAGEMENT OF COPD
Steps of therapy
I (Mild) Short acting BDs
II (Moderate) Regular BD (one / more)
III (Severe) - Bronchodilators
- Inhaled corticosteroids
- Rx of complications
5. Neuropsychiatric
Depression
Disordered sleep
Anxiety
Cognitive function decline
Long term Maintenance and
Prophylaxis Treatment
• Keep off smoking
• Bronchodilators
• Inhaled corticosteroids
• Use/avoidance of other drugs (e.g.
antibiotics, mucolytics ,sedatives)
• Prophylactic vaccination (influenza)
• Pulmonary rehabilitation (multidisciplinary
supports and management)
Pulmonary Rehabilitation
• Structured, multi-disciplinary programme tailored to
one’s needs to improve quality of life, lung function
and reduce breathlessness
Components
• Exercise training
• Nutritional counseling
• Education on lung disease or condition and how to
manage it
• Energy-conserving techniques
• Breathing strategies
• Psychological counseling and/or group support
Pulmonary Eosinophilic Disorders
Normal E counts: Differential: ≤5%, AEC: ≤0.5×109/l
Eosinophilia:
•Mild: AEC 0.5-1.5×109/l
•Moderate: AEC 1.5-5.0×109/l
• Severe: AEC >5.0×109/l
•Hyper Eosinophilic Syndrome (HES):
AEC: >1.5×109/l lasting for 6 months
Lack of evidence for known causes of eosinophilia
Signs and symptoms of organ
involvement/dysfunction
Pulm eosinophilic disorders: Classification
A. Primary pulmonary eosinophilia
Predominant involving lung.
Acute eosinophilic pneumonia
Chronic eosinophilic pneumonia
Systemic disease with lung disease
Churg-Strauss syndrome
Idiopathic hypereosinophilic syndrome
B. Lung disorders with associated eosinophilia
1. Interstitial lung disease, Sarcoidosis, Langerhans cell
histiocytosis, Connective tissue disease
2. Asthma
3. Bronchiolitis obliterans-organizing pneumonia
4. Neoplasms:, Hematological malignancies, Solid organ tumors
C. Secondary pulmonary eosinophilia