By vgreene, 14 February, 2017 Vaccinate: flu [B]. If ≥65 yo: pneumococcal (both PCV13 and PPSV23) [B]; PPSV23 also recommended in pts
By vgreene, 14 February, 2017 If environment risks: Reduce occupational dust/fume/gas and indoor/outdoor pollutant exposure [B]
By vgreene, 14 February, 2017 If smoker, cessation tx [A] using ≥1 first-line tx:1 nicotine gum/inhaler/spray/patch or meds (bupropion SR, varenicline); use drugs along w/ intervention program; counsel9 @ every visit. Efficacy of e-cig as cessation aid uncertain
By vgreene, 14 February, 2017 Long-acting inhaled BD;1 consider additional interventions in select pts for COPD Group B2 pts
By vgreene, 14 February, 2017 Consider for select pts: If hypoxemic per O2 sat/ABG,3 assess for long-term O2 tx.3 For select pts, consider noninvasive ventilation,4 LVRS,5 lung txp,6 bullectomy7
By vgreene, 14 February, 2017 Eval effect: If sx persist, combine LAMA+LABA.1 If no sx improvement by adding second BD, step down to 1 BD. ✓inhaler technique each visit
By vgreene, 14 February, 2017 Start long-acting BD:1 either LAMA (aclidinium, tiotropium, umeclidinium) or LABA (arformoterol, formoterol, indacaterol, olodaterol, salmeterol); if severe SOB, start w/ LAMA+LABA combo1
