Chronic Obstructive Pulmonary Disease (COPD): Summary

00:01 So, to summarize the main learning points of this lecture on COPD. COPD causes largely irreversible airways obstruction and most COPD is due to exposure to cigarette smoke. It presents with exertional dyspnoea, developing over a period of weeks, months, years and it can be confirmed diagnosis using lung function tests which will show obstructive changes. The most effective treatment is to stop smoking and pulmonary rehabilitation. But you can use bronchodilators such as salbutamol and ipratropium and long acting versions of those drugs for symptomatic relief. Inhaled steroids are really not particularly effective but are used in certain circumstances in patients with COPD. So, exacerbations of COPD are an important cause of morbidity and mortality, and as I mentioned, probably the commonest cause of medical admission to a hospital in the UK. These exacerbations are treated by short cause of oral prednisilone and nebulized bronchodilators for those patients admitted to a hospital and perhaps antibiotics if infections seem to be the cause. If the patient has a respiratory failure, then they may need ventilatory support. Specifically non-invasive ventilation for patients presenting with respiratory acidosis, a raised CO2 and a low pH and potentially for select patients you may go as far as mechanical ventilation. However, for many patients that step is probably a step too far and a ceiling of care needs to be established in patients presenting acutely with deteriorations of COPD so that it's known in advance exactly how far the treatment will progress if the patient does not respond to the initial therapies. And thank you for listening.