COPD-Management NICE

Chronic obstructive pulmonary disease- a summary of NICE draft July 2018.

Smoking cessation- Take and document hx of smoking○ pack yrs smoked ie No of cigs / D divided by 20 and multiplied by number of yrs smoked Advice to stop smoking at every opportunity - regardless of age and offer help to do so Consider issuing - unless contraindicated○ nicotine replacement therapy○ vareniciline or○ bupropion+appropriate support Programme for Behavioral support

Inhaled therapy -Short acting beta2 agonists ( SABA ) and Short acting muscarinic antagonists ( SAMA ) as necessary as the initial treatment to relieve breathlessness and exercise limitation - as necessary . NICE advices against using a response to oral corticosteroid ( oral corticosteroid reversibility tests ) to select patients for initiation of inhaled steroid therapy Be ready to discuss the risk of side effects ( including pneumonia ) in people who take inhaled corticosteroids( ICS ) for COPD )

Inhaled combination therapy- This refers to combinations of LAMA , LABA and ICS ie Long acting preparations as opposed to Short acting when initiating treatment LAMA is long acting muscarinic antagonists asglycopyrronium , umeclidinium , aclidinium LABA is long acting beta2 agonists asIndacaterol , formoterol , striverdi

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