What is COPD Disease?
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease, one of conditions of occurrence of which is predominant involvement of distal respiratory tract (bronchi, bronchioles) of lungs that appears under various environmental aggression factors influence.
What causes COPD? Smoking is predominant factor of this pulmonary disease appearance.
Being under significant pathological inflammation during extended period, cough may disturb you, difficulties with breathing are observed, there is shortness of breath.
When bronchi and bronchioles damage become expressed, there is a serious problem of gas exchange in body: to get enough oxygen and to get rid of excess carbon dioxide is becoming more difficult. These changes lead to shortness of breath and other disease’s manifestations.
The term chronic obstructive pulmonary disease (COPD – Correct Diagnosis) is often used along with such diseases as chronic bronchitis and / or emphysema, because chronic bronchitis and emphysema are the most common clinical forms of chronic obstructive pulmonary disease. Furthermore, current treatment of COPD, chronic bronchitis, emphysema are similar and carried out with medications of Canadian HealthCare Mall.
To understand why COPD develops, it is important to understand how lungs are performing. Usually, inhaled air passes from nasopharynx through airways (bronchi, bronchioles) to alveoli. In alveoli, oxygen, we breathe, penetrates through their wall into blood flow. Carbon dioxide passes in reverse direction of blood flow, back into alveoli, and is eliminated during exhalation.
Inhaling smoke while smoking, or being passive smoker inhaling various irritants of gaseous substances or tiny particles, human airways mucosa is damaged causing chronic inflammation, infecting lung tissue.
When lung injury is present there is a situation in which normal breath is a problem with exchange of oxygen and carbon dioxide, as a result alveoli requires treatment.
Tobacco smoking increases risk of developing chronic obstructive pulmonary disease. However, about 20 percent of people who suffer from COPD have never smoked. Other factors that increase risk of disease development include increased sensitivity to inhaled substances.
Especially it concerns:
- inhalation of smoke being passive smoker;
- inhalation of organic, inorganic, house dust or polluted air;
- prolonged exposure to occupational irritants (pairs of acids and alkalis, industrial dust).
Chronic obstructive pulmonary disease (COPD) may be of hereditary character. Genetic risk factors for chronic obstructive pulmonary disease include severe deficiency of alpha 1-antitrypsin, a protein that protects lungs. There are other hereditary defects as well. It can also explain development of COPD in non-smoking patients.
What are the Symptoms of COPD?
COPD initially does not cause or causes a very mild clinical manifestations. COPD symptoms increase considerably, patient’s condition worsens as disease progresses. The most common symptoms of COPD are:
- cough with / without expectoration of sputum;
- shortness of breath during exercise or even at rest;
- increasing fatigue.
COPD should be established , if you have:
- chronic cough with phlegm discharge and / or shortness of breath are risk factors of COPD;
- presence of chronic cough, shortness of breath long before dyspnea appearance;
- signs are not considered separately diagnostic, but presence of these multiple setting increases probability of COPD diagnosis.
In presence of at least one of above symptoms study of respiratory function for the detection of airflow limitation should be conducted, even if you do not have dyspnea.
The main functional syndromes of COPD are:
- bronchial obstruction;
- changes in structure of static volumes, diffusion capacity of lungs;
- decrease in physical performance.
For their study the following methods are used:
- Spirometry allows quick and informative to assess reduction in bronchial tree lumen, as well as to assess degree of process reversibility;
- body plethysmography to diagnose emphysema and to evaluate lung diffusion capacity violation;
- peak flow meter is the easiest and fastest test scores, but has a low sensitivity. It can be effectively used to determine COPD risk groups.
Thus, statement of COPD diagnosis is carried out by summing the following data:
- presence of risk factors;
- cough and shortness of breath;
- steadily progressive bronchial obstruction according to respiratory function;
- exclusion of other diseases causing similar symptoms.
Likely portrait of COPD sufferer is pictured by Canadian Health Care Mall:
- middle or old age;
- shortness of breath;
- cough attacks, especially in the morning;
- complains of frequent bronchitis exacerbations.
COPD Drug Treatment
Short-acting ß2-agonists, sometimes called “rescue” inhalers online, quickly reduce shortness of breath and can be used when necessary as short-term medications. Examples of short-acting beta agonists are salbutamol, levalbuterol, and pirbuterol available on Canadian Health and Care Mall.
Short-acting anti-anticholinergic drugs– ipratropium (Atrovent) improves lung function and reduces severity of symptoms. If disease’s symptoms are mild, you may be advised to use short-acting anticholinergics regularly, as required. If COPD exacerbation is more pronounced, reception of these preparations should be regular.
For patients with more severe disease’s stages, it is recommended in long and regular COPD treatment to apply bronchodilators of prolonged action such as Advair.
Long-acting ß2- agonists such as salmeterol, formoterol, and arformoterol reduce clinical manifestations, improve quality of patients’ life, reduces number of exacerbations.
The use of long-acting anticholinergics – tiotropium (Spiriva), improves lung function, reduces wheezing and worsening of COPD symptoms. According to the latest international and national guidelines, dedicated COPD, tiotropium (Spiriva) -one of the main drugs for COPD treatment.
The combination of anticholinergic drugs with ß2 – agonists of long action is more effective than either drug alone.
In COPD treatment theophylline in form of prolonged release (Theo-Dur, Slo-bid) effectively complements therapy with prolonged forms of bronchodilators, effectively reducing frequency of exacerbations in some people with more severe and stable chronic obstructive pulmonary disease.
Corticosteroids (also called steroids, corticosteroids) are a class of therapeutic agents with pronounced anti-inflammatory properties. Glucocorticoids can be used in form of inhalation, tableted product, or as injection. Inhaled corticosteroids (budesonide, fluticasone) are limited in use of specific indications and are applicable in case of certain bronchial obstruction and COPD exacerbation and it is unacceptable as monotherapy. They can reduce number of exacerbations, but will not change values of functional parameters. It is effectively used in combination with long-acting bronchodilators.
Glucocorticoids are used in form of tablets or injections called systemic glucocorticoids. They are sometimes used for short term use, with COPD exacerbation, but no long-term use because of high risk of side effects and low efficacy.
Mucolytic Means (Ambroxol, Karbotsestein)
They are applied in case of stable COPD to improve expectoration of sputum, to enhance patient’s well-being.
They significantly reduce COPD exacerbations on background of basic therapy with bronchodilators and corticosteroids.
Drug-free COPD Treatment
- The definitive and complete quitting of smoking;
- Oxygen therapy;
- Proper nutrition;
- Rehabilitation programs.
In patients with advanced chronic obstructive pulmonary disease may be low levels of oxygen in blood. This condition is called hypoxemia. The oxygen level can be measured by device that is worn on finger (pulse oximeter) or blood test (arterial blood gas analysis). When treating people with hypoxemia, long-lasting COPD oxygen therapy should be conducted, which improves quality and duration of life. Oxygen therapy is required to be carried out at home.
More than 30% of people with severe chronic obstructive pulmonary disease are not able to eat enough because of disease’s manifestations (dyspnea, fatigue). Unintended weight loss caused by shortness of breath, is usually typical for patients with advanced disease and severe respiratory failure. Irregular diet can lead to malnutrition, which will aggravate COPD course and increase respiratory tract infections risk.
For this reason, in the treatment of COPD is shown as follows:
- Eat small portions and often, with predominance of nutritional products;
- Eat food that requires little time for cooking;
- Relax before eating;
- Keep a diet rich in multivitamin.
Dietary supplements are also a good source of extra calories because they are easily digested and do not require any cooking.
Pulmonary rehabilitation programs may include education, training, resort treatment as COPD therapy, social support for improving quality of life and reducing need for hospitalization. Even people with severe apnea may benefit from rehabilitation programs.