changes in the lung function testing.
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.