Michael W. Nash, MD Family Medicine Clinton County Rural Health Clinic

1. Michael W. Nash, MD Family Medicine Clinton County Rural Health Clinic Understanding COPD

2. COPD • Chronic • Obstructive • Pulmonary • Disease • A.K.A “Emphysema” or “Chronic Bronchitis” • Most common cause is smoking • Other causes such as Alpha-1 Antitrypsin

3. The Lungs

4. COPD

5. COPD vs ASTHMA

6. Diagnosis: • Chronic cough, sputum • Shortness of breath, especially with exertion • Wheezing • Pursing of lips • Common cold hits you harder • History of smoking

7. Diagnosis: • Spirometry (Pulmonary Function Testing) • Chest x-ray, CAT scan suggestive • Arterial Blood Gas (ABG) • Pulse Oximetry Testing (resting vs. exertion)

8. Treatment: • Harder to treat than asthma • Rescue Inhalers • Albuterol, Ipratropium, Levalbuterol • Nebulizers • Maintenance Inhalers • Steroids, Salmeterol, Tiotropium • Medications • Prednisone, Theophylline • Oxygen • More advanced disease, meet certain qualifications

9. Treatment:

10. Treatment: • Exacerbations • Colds, bronchitis, pneumonia often hits harder • Usually requires antibiotics, steroids, increased use of rescue medications • Sometimes requires hospitalization • Bi-Pap • Mechanical Ventilation

11. Other Considerations: • Influenza Vaccination yearly • Pneumococcal Vaccination • Every 5 years until age 65, then one thereafter • Staying as active as possible • Consultation with a pulmonologist • Good nutrition • Advanced Directives

12. Here in Breese: • Testing: PFT, ABG, CXR, CT, Pulse Oximetry • Pulmonary Rehabilitation • Primary Care Physicians trained in tobacco cessation • Three Board Certified Pulmonologists • Flu and Pneumococcal vaccinations • HealthPlex • Resources for Nutrition and Advanced Directives