According to GOLD (Global Initiative for Obstructive Lung Diseases), definition COPD is a disease characterized by airflow limitation that is not fully reversible. The airflow limitation is both progressive and associated with an abnormal response of lungs to noxious particles or gases. 2 It includes chronic bronchitis and emphysema. Chronic bronchitis is characterized by productive cough for three onths or more in at least two consecutive years in the absence of any other disease that might account for this symptom. Emphysema denotes abnormal, permanent enlargement of air spaces distal to terminal bronchiole, with destruction of their walls and without obvious fibrosis. 3 Causes of COPD include smoking, air pollution, occupational exposure and genetic factors (including 1-antitrypsin deficiency).
Chronic bronchitis is responsible for 85% and emphysema for 15%of COPD patients. 4 1 COPD is a leading cause of chronic morbidity and mortality and is a major public health concern.
The World Health Organization (WHO) estimates that there are approximately 1. 1 billion smokers in the world. The use of biomass fuel, such as wood , for cooking increases the risk of COPD by three to four times and is an contributor to COPD prevalence for some parts of the world, particularly in developing countries and rural areas. Air pollution increases the prevalence of COPD by an estimated 2% -for each 10µg increase in particulate matter—10/m3. The WHO has published data placing the worldwide prevalence of COPD at 0. 8%. Other reports place the prevalence of COPD substantially higher, at approximately 4 to 6%. In India there are about 200 million smokers.
The Essay on Chronic Obstructive Pulmonary Disease 2
Chronic Obstructive Pulmonary Disease (COPD) or also known as Chronic Bronchitis or Emphysema is a disease that happens in the lungs of people who smoke. It blocks the airflow to the lungs with black tar / black carbon. Some symptoms are excessive coughing and continuously out of breath. To ease the symptoms you could you use inhalers, steroids, antibiotics or just more oxygen. This disease will ...
Use of wood, dried dung, Crop residue and agricultural wastes as fuel for cooking leads to smoke causing obstructive pulmonary disease. 6 In Kashmir cold climatic conditions and use of wood, saw dust, coal and coke for heating purposes leads to smoky environment and results in common incidence of COPD. 2 Pharmacological management helps to prevent and control symptoms, reduce the severity, frequency of exacerbations and improve health status and exercise tolerance. 7 These agents include anticholinergics like Ipratopium bromide, ympathomimetic drugs like Beta-2 agonists, and Methyl xanthenes like Theophylline. 1 Inhaled anticholinergic drugs are often recommended for use as a first- line therapy for patients with COPD because they provide similar or more effective bronchodilating actions, as well as fewer side effects, as compared to other bronchodialators8 and have lower costs and a greater number of complication-free months compared with those taking theophylline. 9 They act on muscarinic receptors(M3) on bronchial smooth muscles by blocking hyperactive neural reflex which is mediated by vagus.
Beta-2 agonists are the commonest prescribed medications in respiratory practice. 11 They produce their pharmacological effect by acting on beta-2 receptors but because of their wide distribution, a number of side effects occur common among which are tremor and palpitation. 3 These are more common with oral than with inhalation agents a reason for preferential use of inhalation beta-2 agonists. 12 Among methylxanthines, theophylline is commonly used in the treatment of COPD. In vitro they inhibit phosphodiestrase resulting in higher concentration of c-AMP causing bronchodialation.
Another mechanism is the inhibition of cell surface receptors for adenosine. 13 Adverse effects of theophylline are varied and include nausea, gastric upset, vomiting, diarrhoea, headache, insomnia and lightheadedness. 14 4 REVIEW OF LITERATURE COPD has had many names in the past including; Chronic Obstructive Airways Disease, (COAD); Chronic Obstructive Lung Disease, (COLD); Chronic Airflow Limitation, (CAL or CAFL) and Chronic Airflow Obstruction.
The Essay on Chronic Obstructive Pulmonary Disease 3
R.S. has smoked for many years and has developed chronic bronchitis, a chronic obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH = 7.32, PaCO2 = 60 mm Hg, PaO2 = 50 mm Hg, HCO3- = 30 mEq/L. His hematocrit is 52% with normal red cell indices. He is using an inhaled ß2 agonist ...
The definition of COPD that is recognized by both the American Thoracic Society and the European Respiratory Society, is a disorder that is haracterized by reduced maximal expiratory flow and slow forced emptying of the lungs; features that do not change markedly over several months. 15 Chronic Obstructive Pulmonary Disease (COPD), is one of the commonest respiratory conditions of adults in the developed world. Chronic Obstructive Pulmonary Disease poses an enormous burden to society both in terms of direct cost to healthcare services and indirect costs to society through loss of productivity. In middle aged and elderly men in the west, COPD is the fourth commonest cause of death after ischaemic heart disease, lung cancer and cerebrovascular isease. In the UK, it is estimated that 18% of males and 14% of females may have developed features of COPD, and in the USA, 13. 6% of males and 5 11. 8% of females aged 65-74 years have COPD.
According to statistics produced by the American Lung Association, 15 million Americans suffer from COPD and claim the lives of 87,000 Americans in 1992. In the UK, respiratory conditions are the third commonest cause of chronic sickness in working aged people age 45-64 years and is the commonest cause of respiratory related death , and COPD accounts for 56% f days of certified incapacity due to respiratory conditions in males. In 1989, an estimated $7 billion was spent on provision of care for patients with COPD in the USA, with a further cost of $8 billion due to lost productivity. 15 Number of different types of pharmacological agents are being used for the treatment of COPD.
Pharmacological treatment helps in preventing and controlling symptoms, decreasing severity and frequency of exacerbations and improves health status and exercise tolerance. However none of the existing medications for COPD has been shown to alter the long term decline n lung function that occurs with COPD. 7 6 The short term aim of treatment is to reduce symptoms, improve exercise tolerance, improve pulmonary functions and prevent exacerbations. The long term aim is to prevent progressive deterioration of lung functions, delay or Prevent complications and disability and also improve disease related quality of life.
The Essay on The Treatment Of Patients With Communicable Diseases part 1
The Treatment of Patients with Communicable Diseases Contemporary medical care reached many significant results in treating various kinds of diseases. Although for some of the diseases the treatment and cure is yet to be invented. This category of diseases, called communicable includes AIDS, cancer and several other kinds of diseases. For physicians and dentist this is a pretty difficult task to ...
The judicious use of bronchodilators increases airflow and reduces dyspnoea in patients with COPD. 17 Leitch AG et al (1981) in patients with COPD found that oral salbutamol 4 mg and slow release aminophylline 450 mg produced similar nd significant mean increase in FEV1. 18 Ghafouri MA, et al (1984) in a double-blind cross-over design in 23 adult chronic bronchitic patients proved that Ipratropium bromide caused a significant improvement in the mechanics of breathing primarily in the subjects between 46 to 55 years of age. 19 Karpel J. P, et al (1990) in a cross over study found that salbutamol appeared to have a bronchodilating effect equivalent to that of an anticholinergic agent like Ipratropium. 20 7 Georgopoulos D et al (1990) conclude that long-term inhalation therapy with beta 2- agonists in patients with COPD decreases the duration of he bronchodilation produced by the same agents but does not affect the peak response.
Nishimura K et al (1992) while comparing various bronchodilators found that the percentage increase in FEV1 was significantly higher with combined ipratropium bromide and salbutamol than with either drug alone and their was no discernible difference between results obtained with ipratropium bromide versus salbutamol. 22 Thomas P et al (1992) found that theophylline and salbutamol improve pulmonary function in patients with irreversible Chronic Obstructive Pulmonary Disease. 23 Huib. A. M et al (1992) compared terbutaline with beclomethasone and pratropium. It was found that the addition of an inhaled corticosteroid-but not an inhaled anticholinergic agent-to maintenance treatment with a terbutaline substantially reduced morbidity, hyper-responsiveness and airways obstruction in patients with a spectrum of obstructive airway disease.
Nishimura K et al (1993)with the aim of investigating the additive effect of oral theophylline on combined inhaled anticholinergic agent and therapy in patients with stable COPD, conducted a randomised, double blind placebo controlled cross over trial and showed that the additive ronchodilating effect of theophylline ,when used in combination with salbutamol and ipratropium is significant but small in stable COPD. 25 Petty TL (1994) found that during the first 4 hours, combination of ipratropium and salbutamol was more effective than either medication taken separately and efficacy of the two was similar when taken separately. The mean increase in the peak FEV1 values with respect to initial value was 38% for the combination and approximately 30% for the individual medication. 26 Karpel JP (et al) 1994, compared inhaled ipratropium bromide.
The Research paper on Copd Case Study Patient Pneumonia Pulmonary
Client profile: This is an 87-year-old male patient admitted September 16, 2002 for increased work of breathing, dyspnea, COPD exacerbation and bi-lateral bronchopneumonia. I provided care on January 30, 2002, hospital day number nine for the patient. He has a history of COPD due to emphysema, atrial fibrillation, and chronic vertigo. Past surgeries include an aortic aneurysm repair, right hip ...
