Posted tagged ‘COPD’

Spiriva Safe, says the FDA

January 18, 2010

The mainstay of COPD management is bronchodilatation – the local, and national guidelines rely on beta-2 agonists, and anti-cholinergics.  Recent(ish) data from the TORCH study suggested that inhaled corticosteroids increase the risk of fatal and non-fatal pneumonias.  Unopposed long acting beta agonists have been linked with increased cardiovascular death in asthmatics, although not in COPD.  The most recent ‘scare’ has been whether Spiriva increases cardiovascular death in COPD patients.  Today the FDA rule that there is no compelling evidence to that effect.


ITA COPD Physiology Tutorial

September 25, 2009

The ITA COPD Physiology tutorial has been uploaded to Blackboard so you can download and run it on your own PC/laptop.  Follow the week 2 link and you’ll find it in the ITA folder.

Why do COPD patients retain CO2 when given too much oxygen?

August 12, 2009

Most people think that this is due to loss of hypoxic drive, and subsequent hypoventilation.  Although this may be true for a small minority of patients, the majority will retain carbon dioxide due to V/Q mismatching.

Localised low PaO2 in the lung leads to localised vasoconstriction, to areas of poor ventilation have appropriately poor perfusion, redirecting blood to areas of better ventilation.  This protects the COPD patient from V/Q mismatch.

If a high concentration of oxygen is given to a patient, loco-regional low oxygen concentration will be abolished, and with local hypoxic vasoconstriction.  Thus, perfusion returns to normal, but ventilation is poor.  This is termed a shunt, and results in worsening hypoxia, and most importantly, hypercarbia.

Inhaler and Nebuliser Advice

August 12, 2009

Following on from the acute medical department educational meeting today. here is the link to the trust pages on inhaler device choice, and nebulisers.


Come back in a wee bit to download the individual leaflets.