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COPD Action Plan
Aka: COPD Action Plan, Chronic Obstruction Pulmonary Disease Exacerbation Home Plan
- See Also
- COPD Exacerbation Prevention
- COPD Management
- Medications in COPD Management
- Acute Exacerbation of Chronic Bronchitis
- Antibiotic Use in COPD Exacerbation
- COPD
- Chronic Bronchitis
- Emphysema
- Alpha-1-Antitrypsin Deficiency
- COPD Staging
- COPD Action Plan
- Prevention
- See COPD Exacerbation Prevention
- See Pulmonary Rehabilitation Exercises
- Vaccinations: Influenza Vaccine and Pneumococcal Vaccine
- Tobacco Cessation
- Management: Exacerebation Pre-planning
- Emergency prescriptions (available at home in case of exacerbation)
- Supply Albuterol MDI or nebulizer solution
- Supply Prednisone 40 mg orally daily for 5 days
- Supply antibiotic for 5 days to cover in case of uncomplicated Chronic Bronchitis exacerbation
- See Antibiotic Use in COPD Exacerbation
- First-Line: Bactrim, Doxycycline or Amoxicillin
- Alternative: Augmentin, Zithromax or Clarithromycin
- Advanced Directives
- Have a Dyspnea crisis plan for end-stage COPD
- Review Resuscitation Status wishes
- Complete POLST forms and make available at home as well as with primary provider, hospital and EMS
- Consider Hospice for end-stage COPD
- Indications: Phone Contact
- Worsening symptoms (patient should call clinic)
- Dyspnea
- Sputum Color change
- Sputum volume increase
- Phone follow-up (clinic should call patient)
- Routine triage nurse or provider phone call follow-up 2 days after start of exacerbation
- Set up clinic exam within 7 days of COPD exacerbation
- Management: Home
- Continue home management protocol
- See COPD Management for GOLD Criteria and stepped approach to care
- Long-acting Bronchodilators (e.g. Tiotropium, Salmeterol)
- Inhaled Corticosteroids (e.g. Fluticasone) if indicated
- Initiate acute management
- Increase use of Albuterol MDI or nebulizer (rescue Inhaler)
- Start Prednisone 40 mg orally daily for 5 days (see emergency prescriptions listed above)
- Start antibiotic for 5 days (see emergency prescriptions listed above)
- References
- (2014) Presc Lett 21(1): 2