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Patient details Your name: _________________________________________________________________ Your Nurse’s name: __________________________ Tel: ____________________________ Community Respiratory Service Your GP’s name: _____________________________ Tel: ____________________________ Name of your GP Practice: ____________________________________________________ GP Out of Hours Tel: _________________________________________________________ Lung function measurements - to be completed by your doctor or nurse Date FEV1 FVC Sa02 Chronic Obstructive Pulmonary Disease Information about medication and an Action Plan to use if your condition gets worse due to an infection If you would like this publication in large print, Braille, alternative format or in a different language, please contact us on 01603 697300 and we will do our best to help. Supported by an unrestricted educational grant from Boehringer Ingelheim. Published by Norfolk Community Health and Care NHS Trust, October 2011. Please bring this document with you when you see your doctor or nurse about your COPD www.norfolkcommunityhealthandcare.nhs.uk Looking after you locally www.norfolkcommunityhealthandcare.nhs.uk Looking after you locally Information about your medication Your usual treatment Regular medication - to be taken when your condition is stable Inhalers Short-acting Bronchodilators Bronchodilators is the medicine in your inhaler which relaxes the muscles in your airways and makes it easier for you to breathe. Bronchodilators which are shortacting, start to work within about 10 minutes and the effect should last for about four hours. Long-acting bronchodilators Your short-acting medication is called: Name Lunch Evening Bedtime Medication to be taken when necessary Name Some inhalers contain both an inhaled steroid and a long-acting bronchodilator. These are usually taken twice-a-day. Morning Your long-acting medication is called: Long-acting bronchodilators take more time before they have an effect, but last between 12-24 hours. Combination inhalers Dose Instructions Your combination inhaler is called: Other medication Sometimes, tablets or capsules may be prescribed. These are to be taken regularly to help your breathing or reduce the amount of phlegm you produce. ! Your other medication is called: Important Note Make sure you do not run out of your medication. When you ask for a repeat prescription from your GP practice or pharmacist, always allow time (usually two days) for them to arrange it. Pulmonary Rehabilitation Pulmonary Rehabilitation is a special programme designed to help people with lung disease to improve their fitness and learn more about managing their condition. Pulmonary Rehabilitation programmes are very effective at helping people who have a chronic lung disease and are bothered by breathlessness, to improve their fitness, confidence and ability to manage their condition through a personalised programme of exercise and education sessions. Talk to your practice nurse or GP about joining a Pulmonary Rehabilitation programme near you. COPD Action Plan When you are well, be aware of the following: Action: • How much activity you can do each day • Have something to look forward to each day • What your breathing is like when you are resting and when you are active • Plan ahead - pace yourself and allow enough time to do things • How much phlegm you cough up and what colour it is • Exercise every day • Things that make your breathing worse • Eat a balanced diet and drink plenty of fluids • What your appetite is like • Avoid things that make your condition worse • How well you are sleeping • Take your medication as directed by your doctor • Never allow your medications to run out The following are signs that your symptoms are getting worse: Action: • Feeling more breathless or wheezy than usual • Reduced energy for daily activities • Contact your doctor or nurse if you need to talk about increasing your reliever medication and starting antibiotics and/or steroids (see next page) • Coughing up more phlegm • Allow more time for things • Change in colour of phlegm • Get plenty of rest • Poor sleep and/or symptoms waking you in the night • Use relaxation and controlled breathing techniques • Eat small amounts more often and drink enough fluids The following are signs of a severe attack: Action: • Breathlessness and cough getting worse • Phone your doctor for an urgent appointment or home visit • You are not able to carry out your normal daily activities • Your medications are not working The following are danger signs: Action: • Very short of breath when you are at rest, with no relief from medication • Dial 999 for an ambulance or ring the GP Out of Hours service • Chest pains • High fever • Feelings of agitation, fear, drowsiness or confusion Medication to use when your symptoms are worse • Be aware of signs that your breathing or cough is getting worse and use the colour-coded Action Plan (see middle pages). • Take immediate steps to increase your treatment and take additional medication as this may reduce the risk of your breathing becoming worse. Your GP may allow you to have reserve antibiotics and steroids at home to use if your symptoms become worse. If you are in any doubt about what to do, contact your doctor or nurse, or the Out of Hours service for advice. Things you can do to keep well Try to exercise every day Walk for 10 minutes, three times-a-day. You will not cause any harm by getting slightly short of breath Talk to your nurse or GP about joining a Pulmonary Rehabilitation course near you Maintain a healthy body weight and eat a balanced diet • Extra reliever - to reduce breathlessness Take up to _________ puffs of ___________________________________________ every __________ hours Use inhalers through a spacer for maximum effect • Antibiotic - to use if your sputum becomes coloured or the amount increases due to infection Stop smoking Go smokefree It is never too late for this to be beneficial Call Smokefree Norfolk for free on 0800 0854 113 Have a Have a Avoid places where other people are smoking Take __________ mg of _________________________________________________ ______________times-a-day, for seven days • Prednisolone (steroid) tablets - to use to reduce inflammation in the lungs when your breathing is bad Take six 5mg tablets as a single dose, once-a-day, for seven days ! Important Note Make sure you do not run out of your medication. When you ask for a repeat prescription from your GP practice or pharmacist, always allow time (usually two days) for them to arrange it. flu vaccination pneumococcal vaccination every year (this only needs to be done once) In very Wear warm clothing cold weather, make sure you have enough heating indoors when you go outside in cold weather, and carry your reliever inhaler with you Make sure you know how to use your inhalers properly. Your nurse will be able to help Avoid sedatives or too much alcohol