By vgreene, 7 April, 2023 Vaccinate COVID 19 according to nat l recs B Flu annually A Tdap if not previously received B Zoster if 50 yo B CDC recommends 1 dose of PCV20 or 1 dose of PCV15 followed by PPSV23 in pts w COPD B
By vgreene, 7 April, 2023 If environment risks Efficient ventilation nonpolluting cooking stoves etc B avoidance of irritants if possible D
By vgreene, 7 April, 2023 If smoker cessation tx A using 1 first line tx nicotine gum lozenge inhaler spray patch or meds bupropion nortriptyline use drugs along w intervention program counsel8 at every visit Efficacy of e cig as cessation aid controversial
By vgreene, 7 April, 2023 Long acting inhaled BD combo 1 consider additional interventions in select pts for COPD Group B2 pts
By vgreene, 7 April, 2023 Pulmonary rehab7 recommended A Encourage physical activity No demonstrated benefit for integrative care or telehealth B
By vgreene, 7 April, 2023 Consider for select pts If hypoxemic per O2 sat ABG 3 assess for long term O2 tx 3 For select pts consider noninvasive ventilation 4 procedural interventions5 6
By vgreene, 7 April, 2023 Eval response De escalate tx when appropriate Check inhaler technique every visit
By vgreene, 7 April, 2023 Prescribe rescue short acting BD SABA or SAMA to all pts for immediate sx relief SABA options albuterol levalbuterol MDI NEB SAMA ipratropium MDI NEB
By vgreene, 7 April, 2023 Start LABA LAMA 1 o LABA options arformoterol formoterol olodaterol salmeterol o LAMA options aclidinium glycopyrrolate revefenacin tiotropium DPI MDI umeclidinium o LAMA LABA combo options aclidinium formoterol glycopyrrolate formoterol tiotropium olodat