Comprehensive management of COPD characterized by chronic shortness of breath, cough and sputum, including spirometry-based staging, drug therapy and regular follow-up.
Indication
- Chronic cough and sputum in patients over 40 with a long smoking history
- Progressive shortness of breath that worsens with exertion
- Patients with occupational exposure to dust, fumes or chemicals
- Recurrent lower respiratory tract infections
- Patients previously diagnosed with COPD who require regular follow-up
- Patients needing treatment adjustment after an acute exacerbation
- Younger patients with suspected alpha-1 antitrypsin deficiency
Preparation
- Discontinue short-acting bronchodilators 4-6 hours and long-acting ones 12-24 hours before spirometry
- Avoid smoking and heavy meals for 1 hour before the test
- Bring a current list of medications and inhalers
- Bring previous chest X-rays and pulmonary function tests
How it's performed
- Detailed respiratory history, smoking pack-year calculation and questioning of occupational exposure
- Physical examination (auscultation, oxygen saturation and pulse measurement)
- Spirometry with assessment of FEV1/FVC before and after bronchodilator
- GOLD staging (1-4 from mild to very severe) and symptom scoring (mMRC, CAT)
- Chest X-ray, and when needed, thoracic CT and arterial blood gas analysis
- Individualized inhaler therapy, smoking cessation support and a vaccination plan
Post-procedure
- Follow-up visit every 3-6 months for stable patients
- Annual spirometry and chest X-ray if needed
- Review of inhaler technique at each visit
- Influenza, pneumococcal and other appropriate vaccinations
- Special follow-up visit within 4-8 weeks after an acute exacerbation
Risks
- Progressive loss of lung function and decreased exercise capacity
- Hospitalization and respiratory failure due to frequent exacerbations
- Increased risk of oral candidiasis and pneumonia with inhaled steroids
- Bone loss and elevated blood sugar with systemic corticosteroid therapy
- Development of accompanying heart disease or pulmonary hypertension
FAQ
What is the difference between COPD and asthma?
COPD is an airway disease with limited reversibility, usually caused by long-term smoking or exposure to harmful substances. Asthma typically begins at younger ages, varies with allergic triggers and is largely reversible.
If I quit smoking, will my lungs return to normal?
Quitting smoking is the most effective step to slow disease progression. Although existing damage is not fully reversed, the rate of lung function decline slows significantly and exacerbations decrease.
How long does the spirometry test take?
It takes about 15-30 minutes on average; the time may extend slightly when measurement after bronchodilator is performed.
Which vaccines are recommended in COPD?
Annual influenza vaccine, pneumococcal vaccines, shingles vaccine in the appropriate age group and current COVID-19 vaccination according to the latest guidelines are recommended.
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