Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is also known as Chronic Bronchitis and Emphysema. This is a lung disease predominantly caused by long-term smoking. The sufferer’s ability to exchange air with the environment is compromised either by thickened, scarred bronchi (the large airways), as seen in chronic bronchitis, or by the destruction of the elastic alveoli (the small air sacs), as seen in emphysema. Each of these processes creates obstruction and air trapping.
In many people, this disease is characterized by airway inflammation, the overproduction of mucus, and the loss of cilia (the tiny hairs that line the airways and propel mucus up and out of the lungs). Thus, people with COPD often cough up large quantities of mucous and are short of breath.
COPD usually starts when the sufferer is in one’s fifties or sixties after long-term smoking. It is a disease marked by progressive lung destruction. In the beginning, a person may notice symptoms only with exertion, but later in life may notice shortness of breath with even routine activity. Lung scarring and the overproduction of mucus make it much easier for bacteria to thrive in the lungs of a person with COPD. Thus, even simple upper respiratory tract infections and chest colds are potentially serious in a COPD patient.
Treatment (Maintenance and Prevention)
Treatment of COPD focuses on dilating the airways, expelling and reducing mucus, preventing inflammation and using antibiotics liberally in the advent of any upper-respiratory tract infection. Once a crisis is over, the maintenance phase of treatment consists of frequently using Atrovent and Albuterol inhalers. Atrovent is an inhaled medication that decreases the secretion of mucus and relaxes the muscles of the bronchi, causing them to dilate. Inhaled Albuterol also relaxes airway muscles.
Each of these inhalers must be used every four to six hours for maximum efficacy. The long-acting airway dilators, Serevent and Foradil, provide sustained dilation for up to 12 hours. Guiafenessin may help thin mucous secretions. Steroids, either given orally or through inhalers, reduce airway inflammation, though it is the person with severe COPD that receives the most benefit from oral steroids.
Treatment (Flare ups/Exacerbations)
An acute flare up occurs when a person with COPD develops a flare in his or her symptoms. These events are typically brought on by viral upper-respiratory tract infections (i.e., chest colds) or allergies. If you notice an increase in sputum production, a change in color to brown or green, shortness of breath, or increased cough or fever, you should suspect a flare in your COPD. Consult with a physician so you can be evaluated for possible pneumonia. Flare ups are treated with oral steroids, antibiotics, and inhaled bronchodilators.
