(N Engl J 2002, 347 supports treatment of acute exac but doesnt say which ABX) Get chest x-ray (prompts change in short-term 21%)īactrim, doxy, or amox for purulent sputum or acute exac. Methylxanthines Offer No Benefit in Acute COPD Exacerbations ( BMJ 2003 Sep 20) Load aminophylline 5 mg/kg over 0 minutes, then. P Pulmonale-increased ps in II, III, AVFĪdrenergic state of acute attack leads to white cell demarginalization (epi given to a pt does same thing) Note: Retrocardiac space can be eliminated by cor pulmonale giving enlarged right ventricle. Polycythemia means they can become cyanotic very easily and yet still be comfortable. Hypertrophy of submucosal glands and goblet cells. NIPPV should be first line therapy in all exacerbations with respiratory failure (Cochrane Review BMJ. Why do they decompensate? PE, Pneumonia, URI, CHF/Ischemia/Dysrhythmia, Med changes or noncompliance, or Pneumothoraxĭo not sedate COPDers, may cause resp.
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