By vgreene, 5 March, 2019 Ventilation. Consider NPPV in select pts (eg, if persistent daytime hypercapnia)4
By vgreene, 5 March, 2019 Eval response, escalate and de-escalate as needed. ✓inhaler technique every visit
By vgreene, 5 March, 2019 Continue short acting BD for sx rescue SAMA ipratropium SABA albuterol levalbuterol for all pts
By vgreene, 5 March, 2019 If on LAMA+LABA: If eos ≥100/uL consider triple tx (ICS+LAMA+LABA) using multiple inhalers. If eos
By vgreene, 5 March, 2019 If on ICS+LABA: Add LAMA; either remove steroid2 (LAMA+LABA: (aclidinium/formoterol, glycopyrronium/formoterol, tiotropium/olodaterol, umeclidinium/vilanterol) or go to triple tx1 (ICS+LAMA+LABA) using multiple inhalers
By vgreene, 5 March, 2019 If on single LABA or LAMA: switch to LAMA+LABA combo (aclidinium/formoterol, glycopyrronium/formoterol, tiotropium/olodaterol, umeclidinium/vilanterol); or if eos ≥300/uL (or ≥100 in pt w/ 2+ mod/severe exac or 1+ hospitalization; or if hx/exam consistent