Treatment Notes for COPD
Below are some notes from a practising GP who treats COPD
The treatment here varies depending on reversibility testing for B agonists and steroids. Generally, patients who have attended hospital respiratory clinics will have had Pulmonary Function Tests. All new diagnoses of COPD have to be tested to fulfil scores in the new GP GMS contract. Most GPs are now becoming familiar with this and have nurses who perform spirometry and reversibility testing.
COPD patients are generally mild, moderate or severe. If a patient does not respond to treatment i.e. steroids, then they generally will not be on them, so possibly not a measure of seriousness of condition. Usually they get a little benefit from bronchodilators and steroids. Steroid inhalers seem to reduce the risk of serious exacerbations, even if not changing peak flow etc.
Other Drugs Used:
Ipratropium Bromide (Atrovent). Occasionally used in asthma as a mild bronchdilator but most useful in COPD. Short acting so less good than:
- Tiotropium (Spiriva), which is relatively new and taken once daily. It is a useful drug and has improved several of my COPD patients.
- Long acting oral theophyllines now being used more in COPD.
- Oxygen intermittent and continual through concentrators.
