By vgreene, 25 April, 2023 Prevent future exac w long acting BD and other maintenance tx based on GOLD COPD group recommendations
By vgreene, 25 April, 2023 Start w short acting beta 2 agonists short acting anticholinergics for mild exac
By vgreene, 25 April, 2023 Test for COVID 19 w new or worsening resp sx fever loss of taste and or smell Positive SARS CoV 2 testing does not exclude the potential for other resp pathogens Pts w COVID 19 should continue taking PO and inhaled resp meds for COPD
By vgreene, 25 April, 2023 Give PO steroids prednisone 40 mg day for 5 days A May be less effective in pts w low eosinophil levels
By vgreene, 25 April, 2023 If uarr bacterial signs Consider PO abx for 5 days in pts w uarr SOB uarr sputum uarr purulence or uarr purulence either uarr SOB or uarr sputum Use controversial nbsp nbsp When indicated can darr recovery time hospitalization duration darr early relapse
By vgreene, 25 April, 2023 Increase short acting inhaled BDs SABA albuterol levalbuterol MDI NEB SAMA ipratropium MDI NEB C Dose 1 puff q1h x2 3 doses then q2 4h based on response BD may suffice for mild exac Use spacer or NEB No significant FEV1 difference between MDI w or w o spa