This is a normalappearing 59yearold man presenting to the clinic with complaints of shortness of breath that is limiting his activity and affecting his
quality of life. Given the results of spirometry and patient history, patient has COPD in addition to a history of CAD, daily pain from cervical
radiculopathy, and chronic cough. Cardiac pathology as a cause of current symptoms is unlikely, given lack of chest pain and recent normal
cardiovascular stress test. The patient states that he is adherent to his current medication regimen
What subjective and objective information indicates the presence of COPD?
.b. What additional information is needed to fully assess this patient’s COPD?
.a. What are the goals of pharmacotherapy in this case?
.b. What nondrug therapies might be useful for this patient?
.c. What feasible pharmacotherapeutic alternatives are available for treating COPD?
.d. Create an individualized, patientcentered, teambased care plan to optimize medication therapy for this patient’s COPD and other drug therapy
problems. Include specific drugs, dosage forms, doses, schedules, and durations of therapy
.a. What information should be provided to the patient to enhance adherence, ensure successful therapy, and minimize adverse effects?
.b. Describe how care should be coordinated with other healthcare providers.1.
.a. What information should be provided to the patient to enhance adherence, ensure successful therapy, and minimize adverse effects?
.b. Describe how care should be coordinated with other healthcare providers.
Followup: Monitor and Evaluate
.a. What clinical and laboratory parameters should be used to evaluate the therapy for achievement of the desired therapeutic outcome and to detect
and prevent adverse effects?
.b. Develop a plan for followup that includes appropriate time frames to assess progress toward achievement of the goals of therapy.
. Describe and compare the expectations for deterioration in pulmonary function in patients with COPD who have quit smoking with those who
continue smoking. In particular, emphasis should be placed on expected patterns of change in FEV1, FVC, and general health over time in years.
. Research and describe the appropriate use of inhaled corticosteroids for the management of stable COPD. Be able to compare and contrast the
benefits and risks of this therapy.
. Analyze the safety surrounding the use of βblockers in patients with COPD versus those with asthma
