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Table Of Contents

Introduction
Main points
What is new in this third edition
Why COPD is important
How important is COPD?
What is the economic burden of COPD?
Risk factors
Chronic asthma
Chronic bronchitis
Emphysema
Small airways disease
COPD – a mixed spectrum of diseases
Presentation and history
Symptoms
History taking
Clinical signs
Summary
Spirometry and lung function tests
Spirometry
Flow/volume measurement
Early screening for COPD
Assessment
Making the diagnosis and establishing a baseline
Bronchodilator reversibility
Corticosteroid reversibility
Excluding alternative and coexisting pathologies
Disability and handicap
Assessing breathlessness
Assessing walking distance
Assessing the impact of the disease on daily activities
Impact of the disease on psychosocial functioning
Assessing health status
Smoking cessation
Why do people smoke?
How can smokers stop smoking?
Nicotine replacement therapy
Bupropion
Helping patients to stop smoking
Pharmacotherapy
BRONCHODILATORS
How do bronchodilators work?
Short-acting bronchodilators
Long-acting inhaled bronchodilators
Oral long-acting bronchodilators
Nebulised bronchodilators
CORTICOSTEROID THERAPY
The rationale for using corticosteroids
The NICEguidelines advice on inhaled steroids in COPD
New clinical information on inhaled steroids
What are the implications for primary care?
Is there a role for long-term oral steroids?
Steroids for acute exacerbations
Salmeterol/fluticasone studies
Main point
Formoterol/budesonide studies
MUCOLYTICS
Pulmonary rehabilitation
Evidence for the effectiveness of rehabilitation in COPD
Why rehabilitation programmes are needed
The role of the primary health care team
Other forms of therapy
Oxygen therapy
Surgery
Vaccinations
Nutrition
Exercise
Social and psychological issues
Severe breathlessness and palliative care
Acute exacerbations and referral to hospital
Defining an exacerbation
Management of the acute exacerbation
Natural history of an exacerbation
Treatment in the community
Recurrent exacerbations
Prevention of acute exacerbations
Hospital-at-home schemes for acute exacerbations
Respiratory failure
Treatment of associated conditions
Consideration of specialist referral
Definition
Making a diagnosis
COPD – a multi-system disease
New recommendations on drug treatment
Hospital-at-home schemes
Treatment of exacerbations
Self-management action plans
Palliative care
Assessment of patients with COPD
Follow-up and monitoring in primary care
The GOLD guidelines
What is GOLD?
The GOLD definition of COPD
Goals of management
Assessing and monitoring disease
Reducing risk factors
Managing stable COPD
Managing exacerbations
Future research
Anti-inflammatory therapies
Drug therapy of the future
Antiproteases
Alpha-1 antitrypsin
Antioxidants
Pulmonary vasodilators
Organisation and training needs
Finding the patients
The practice nurse’s role
Protocol and audit
Glossary
Useful addresses
Index
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COPD in Primary Care

COPD in Primary Care

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Published by Fitri Indahyanti

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Published by: Fitri Indahyanti on Dec 13, 2011
Copyright:Attribution Non-commercial

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07/08/2012

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