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Writer's pictureVasudev Bendre

Chronic Obstructive Pulmonary Disease/Disorder [COPD]


Chronic obstructive pulmonary disease/disorder or COPD is a progressive inflammatory lung disease characterized by increasing breathing difficulty.

COPD can also be known for its airflow resistance which is not reversible, which eventually decreases airflow in and out of your lungs.

COPD is becoming a more common infectious disease. It's now the third highest cause of all deaths globally.


Symptoms:

COPD may have no symptoms or only mild symptoms in the early stage. But as the disease gets worse symptoms become more severe.

Quite a time, people with COPD experience episodes of severe breathlessness known as ‘Exacerbations’.

Major symptoms of copd are;

  • Shortness of breath, mostly while doing everyday activity.

  • Fatigue

  • Cough produces a lot of mucus.

  • Chest Tightness

  • Wheezing

  • Phlegm

  • Fingernails become bluish in color.

  • Loss of weight without trying.

Causes:

The main causes of COPD include,

  • Tobacco use is the leading cause of COPD in developed countries.

  • COPD is common in the developing world among people who have been exposed to fumes from burning cooking fuel and heating in poor ventilation homes.

  • Rarely, Patients with COPD may have a defect in their DNA, the code which informs your body how to keep functioning. This condition is known as "alpha-1 antitrypsin deficiency," or AAT deficiency. If you have this condition, your lungs do not have much of a protein that protects them from harm. This could result in severe COPD.[2]

Risk Factors:

  • Tobacco Smoking: The major reason why 75% of people have COPD is Smoking. Passive smokers also get infected with COPD to a great extent.

  • Continues exposure to Fumes, chemicals, vapors, air pollution, and dust inhaled where patients work.

  • Age is also one of the factors which need to be considered. People who are diagnosed with COPD are mostly above 40 years of age when their symptoms begin.

  • Asthma: Patients with a history of asthma have a higher risk of getting COPD than the people who are not diagnosed with asthma earlier. But on the other hand not all the Asthma patients will get diagnosed with COPD.

Types of COPD:

There are three types of COPD,

Chronic bronchitis (Blue bloater):

In this case, The lining of the bronchial tubes is constantly irritated and inflamed due to foreign allergic particles, which leads to a long term cough with heavy mucus production.

Period : it can lasts unto 3 months to 2 years in a row

Types of chronic bronchitis:

  1. Simple chronic bronchitis: In this case, patients may have a productive cough but the chances of airflow obstruction is very low.

  2. Asthmatic chronic bronchitis: In this case, the patient have hyper- reactive airway which leads to bronchospasm and wheezing

  3. Obstructive chronic bronchitis: In this case, the patient might develop emphysema. This may happen mainly because of smoking.

Causes:

  • It is caused due air pollutants mostly

  • Cigarette smoking (passive and active), dust particles, fumes, and vapors

Symptoms:

  • Productive cough

  • Shortness of breath

  • Chest discomfort

  • Fatigue

  • Mucus production

  • Weakness

  • Coughing

For more information, visit our post 'CHRONIC BRONCHITIS'

Emphysema ( pink bloater)

This conditions can cause shortness of breath due to over inflation of the alveoli (the air is trapped into the lungs due to blockage in the air sacks)

Causes:

  • Cigarette smoking

  • Bronchial tube

  • Damage

  • Inherited

Symptoms:

  • Shortness of breath

  • Wheezing

  • Coughing

  • Fatigue

Asthma:

Asthma is a long-term lung disease that inflames and narrows the airways, tubes that carry air into and out of your lungs, causing symptoms like shortness of breath and coughing.

Symptoms:

  • Wheezing ( whistle like sound during the breathing)

  • Shortness of breath.

  • Coughing

  • Chest tightness, pressure or pain.

  • One might find it difficult to walk

Causes:

  • Family history of asthma

  • Allergens like pollen, dust mites, mold, and pet dander.

  • Change in climate, pollution, smoking.

  • Exercise, distress, etc.

  • Obesity

Diagnosis:

  • Doctors also ask for your symptoms, whether you smoke or been in contact with chemicals, dust or smoke to work.

  • The commonly known test used for diagnosis of COPD is Spirometry.

  • Doctors also use Lung function tests, imaging tests, and even blood tests.

  • CT Scan

  • Arterial blood gas test

  • Chest X-rays

Treatment:

  • At present there is no cure for COPD, but treatment available will help slow its progression and control the symptoms.

  • For smokers, terminating smoking is the most effective way of avoiding further damage from COPD.

  • Inhalers can be started which contain medicines which help restore the airways by expanding them and reducing the inflammation.

For more information visit 'ASTHMA'


Available Medications for COPD:


Note: These medications are mentioned just for your knowledge and understanding. Do not take it directly. Please consult your physician/doctor before.


Short-Acting Bronchodilators:

These medicines work quickly to relax the muscles surrounding your airways, alleviating symptoms such as coughing and breathlessness. Its effect lasts for about 4-6 hrs.

Such drugs include :-

  1. Albuterol (ProAir HFA, Ventolin HFA)

  2. Ipratropium (Atrovent)

  3. Ipratropium bromide and albuterol (Combivent)

  4. Levalbuterol (Xopenex HFA)

  • How to use: These drugs should be inhaled with the help of inhalers twice or thrice per day as prescribed by the physician.

Long-Acting Bronchodilators:

These drugs are recommended if you suffer from symptoms throughout the day.

The working is similar to the short-acting bronchodilators except that its effect lasts for about 12 hrs so it should be given once or twice a day only.

The 2 types of long acting bronchodilators used are;

  1. beta-2 agonist inhalers – such as salmeterol, formoterol and indacaterol.

  2. antimuscarinic inhalers – such as tiotropium, glycopyrronium and aclidinium.

  • How to use: These drugs too should be inhaled with the help of an inhaler once or twice a day only as prescribed by a physician.

Steroid Inhalers:

These are mainly prescribed if the patient is still experiencing breathlessness and also experience exacerbations.

Corticosteroid medicines are most widely used steroids for COPD which help to reduce the inflammation present on either side of airways.

Mostly it's a combination treatment with long-acting bronchodilators for better results.

  1. There are some tablets which will be prescribed by your physician depending on patients’ symptoms and its severity.

  2. Some of the tablets used as treatments are as follows;

  • Theophylline tablets

  • Steroid tablets

  • Usually a steroid tablet course is recommended for a maximum to 5 days.

  • Steroid dose for longer duration should be prescribed by a COPD specialist Physician only.

  • Antibiotics

  • Roflumilast Tablets

These tablets are new medicines which can be used for COPD.

It is mainly recommended for patients whose symptoms became 2 times adverse in the last 1 year and who are already on Inhaler treatment.


Pulmonary Rehabilitation:

Pulmonary rehabilitation is a highly specialized activity and outreach program developed to aid people with respiratory issues such as COPD.

The program consist of;

  • physical exercise training tailored to your needs and ability – such as walking, cycling and strength exercises [1]

  • education about your condition for you and your family [1]

  • dietary advice [1]

  • psychological and emotional support [1]


Medicine through Nebulizer:

Nebulized medicines are used when patients are ineffective with medicines used through inhalers.

A machine is used here to turn liquid medicine into a fine mist that you inhale through a mouthpiece or a face mask. It allows a large dose of medicine to be taken all at once.[1]



There are some other methods of treatments for COPD which includes;


Long-term Oxygen treatment:
  • If patients are not getting any positive effects with medicines Oxygen Treatment might help them control COPD.

  • Long term oxygen treatment involves inhalation of oxygen through oxygen tubes or masks for at least 15-16 hours per day.

  • For this treatment your physician might advise you to take it at your home.

Surgery:
  • It is considered for only some people having severe COPD and which is not controlled by any prescribed medicine.

  • There are 3 major operations which can be done are;

  • bullectomy – an operation to remove a pocket of air from one of the lungs, allowing the lungs to work better and make breathing more comfortable.[1]

  • lung volume reduction surgery – an operation to remove a badly damaged section of lung to allow the healthier parts to work better and make breathing more comfortable.[1]

  • lung transplant – an operation to remove and replace a damaged lung with a healthy lung from a donor.[1]

4 Types of Exercises for COPD :-


(1) Stretching exercises: It lengthens your muscles which eventually makes you more flexible.

(2) Aerobic exercises: Walk at a stable, rhythmic pace by using large muscle groups. This form of exercise strengthens your heart muscle. This improves your respiration by allowing your body to use oxygen more efficiently. If you have COPD, two good aerobic activities are walking and using an exercise bike.

(3) Strengthening exercises: It Involves stiffening muscles until they tire Once you do it for your upper chest, it can help strengthen your respiratory muscles.

(4) Breathing exercises: Doing breathing exercises help you get more oxygen, breath with minimum effort and which eventually strengthen your respiratory muscles. One with COPD should do it at least 3-4 times a day. Some known breathing exercises are ;

Pursed-lip breathing:

  • Relax your neck and shoulder muscles.[3]

  • Breathe in for 2 seconds through your nose, keeping your mouth closed.[3]

  • Breathe out for 4 seconds through pursed lips. If this is too long for you, simply breathe out for twice as long as you breathe in.[3]

Diaphragmatic breathing:

  • Lie on your back with knees bent. You can put a pillow under your knees for support.[3]

  • Place one hand on your belly below your rib cage. Place the other hand on your chest.[3]

  • Inhale deeply through your nose for a count of three. Your belly and lower ribs should rise, but your chest should remain still.[3]

  • Tighten your stomach muscles and exhale for a count of six through slightly puckered lips.[3]

Note: Consult with your physician before applying these exercise in your daily routine while dealing with COPD, as the precautionary purpose


Precautions:

  • Quit Smoking (both active and passive smoking)

  • Prepare your diet properly and Exercise daily.

  • Give rest to your Body

  • Rest is essential for a healthy life. Still, if anyone has COPD his/her sleep pattern can get disturb affecting his/her mental health. Some helpful things which need to be consider while resting are;

  • Avoid taking a nap between free time to get yourself a sound sleep at night.

  • Do not exercise at least 2 hours before going to sleep.

  • Avoid intake of caffeine after 5pm.

  • Keep planned bedtime and wake-up time.

  • Taking prescribed medications on time, if any.


REFERENCES:

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