Escolar Documentos
Profissional Documentos
Cultura Documentos
Presented to the
Department of Physiology and Pharmacology
University of Perpetual Help Binan
College of Medicine
By:
JelineSymbaC.Celocia
Medicine III
Salient Features
28 year old female
(+) Progressive cough and breathlessness for 23years
(+) wheeze
(+) chest tightness
(+) nocturnal cough
(+) family history of early onset COPD
Spirometric
ManeuverResults:
FEV1 of 49%
FEV1/FVC of 52%
TLC of 144%
RV of 237%
MMC score of 4
Blood tests
normal
Alpha-1
Antitrypsin
normal
Initial Results
Subjected to
SteroidTrial
NOFEV1
REVERSIBILITY
DIAGNOSIS
Extensive Centrilobular
Emphysema with an Upper
Lobe Predominance
Figure 1. Pathogenesis
of Emphysema.
Click icon to add clip smoke
art
Chronic exposure to cigarette
which
leads to inflammatory and immune cell
recruitment within the terminal spaces of
the lung
Figure 2. Pathophysiology of
Emphysema.
Cigarette Smoking
Click icon to add clip art
Inflammatory cell
recruitment
Perforation & Obliteration of
walls
ECM destruction
Expiratory
wheeze
Assessment and
Management of COPD
(GOLD Classification,
2015)
Click icon to add clip art
Table 3. Non-pharmacologic
Management of COPD
Click icon to add clip art
Figure 3. Therapeutic
Management for COPD
Click icon to add clip art
Efficacy
Suitability
Safety
Affordability
Total
Albuterol
++
++
+++
Formoterol
+++
++
++
Salmeterol
+++
++
++
++
Efficacy
Suitability
Safety
Affordability
Total
Ipratropium
++
++
++
++
Tiotropium
+++
+++
++
THANK YOU.
References:
Conroy, K., Miller G. Shipley, M. Emphysema and COPD in a young woman.
Elsevier Ltd. Respiratory Medicine Case Reports 12. 2014; 51-52.
Kasper, DL. Hauser, SL. Jameson, JL. Fauci, AS. Longo, DL. Localzo, J.
Harrisonss Principles of Internal Medicine, 19th edition. McGraw Hill
Companies. 2015; 1700-1707.
Katzung, BG. and Trevor, AJ. Basic and Clinical Pharmacology, 13th edition.
McGraw Hill Companies. 2015; 352-353.
Global Initiative for Obstructive Lung Disease. Pocket Guide to COPD Diagnosis,
Management and Prevention. 2015.
The National Formulary Committee. Philippine National Drug Formulary: Essential
Medicines List, 7th edition. Volume I. 2008. Department of Health. Accessed
at www.fda.gov.ph.
The Philippine Drug Price Reference Index List. 2013. Department of Health.