COPD Chronic Obstructive Pulmonary Disease

COPD

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the United States and worldwide. This is not a contagious disease however, there is no know cure for COPD. COPD is a disease of the lungs caused by damage to the airways primarily due to cigarette smoking although prolonged exposure to dust, chemicals and pollution also cause COPD.

COPD: SYMPTOMS

Chronic Obstructive Pulmonary Disease (COPD) is a disease, which has specific symptoms including:

A cough;

Sputum or mucus production;

Shortness of breath with exercise;

Wheezing, or a whistling sound when breathing; and 5) Tightness in the chest. (National Heart Lung and Blood Institute: Diseases and Conditions Index, 2007)

It is noted by the National Heart Lung and Blood Institute: Diseases and Conditions Index (2007) that the individual with COPD generally has a cough that does not go away and that the individual coughs up a great deal of mucus, with both of these symptoms occurring often "...years before the flow of air in and out of the lungs is reduced." (National Heart Lung and Blood Institute: Diseases and Conditions Index, 2007) it is noted however, that "not everyone with a cough and sputum production goes on the develop COPD" and as well "not everyone with COPD has a cough." (National Heart Lung and Blood Institute: Diseases and Conditions Index, 2007) the symptoms severity is dependent upon the quantity of the lung that has experienced destruction and that if the individual stop smoking that less of the lung will be destroyed. COPD is a disease of the lungs in which damage has been caused to the lungs making breathing difficult due to obstruction of the tubes that transport air to and from the lungs causing difficulty in air passing through these tubes. The most common cause of COPD is stated to be "cigarette smoking" as well as inhaling other types of irritants such as dust, chemicals or pollution over a prolonged period. The airways that transport air to and from the lungs "branch out like an upside-down tree, and at the end of each branch as many small, balloon-like air sacs called alveoli." (National Heart Lung and Blood Institute: Diseases and Conditions Index, 2007) Individuals who are healthy have airways that are "clear and open." These air sacs are "small and dainity, and both the airways and air sacs are elastic and springy." (National Heart Lung and Blood Institute: Diseases and Conditions Index, 2007) When air is breathed in each of the air sacs inflate with air similar to a balloon, when air is breathed out the air sac deflates, and the air is expelled out. COPD is characterized by these "airways and air sacs" experiencing a loss to their shape resulting in less air traveling in and less air being expelled out. This is because:

1) the airways and air sacs lose their elasticity;

2) the walls between many of the air sacs are destroyed;

3) the walls of the airways become thick and inflamed; and 4) Cells in the airways make more mucus than usual which tends to log the airway." (Ibid)

The development of COPD is a slow process and is generally diagnosed in individuals who are "middle-aged or older people." (National Heart Lung and Blood Institute: Diseases and Conditions Index, 2007) COPD is stated to be a "major cause of death and illness" (National Heart Lung and Blood Institute: Diseases and Conditions Index, 2007) COPD has no cure with no reversal to the airways and lung possible however; there are actions the individual can take in order to feel more healthy and also in order to slow the progression of damage.

II. TREATMENT of COPD

The work entitled: "Chronic Obstructive Pulmonary Disease" published in the Journal of American Medical Association states the COPD is the term that is used to describe 'related lung diseases: chronic bronchitis and emphysema. 'Chronic Bronchitis' is inflammation and eventual scarring of the bronchi (airway tubes). Emphysema is enlargement and destruction of the naively (air sacs) within the lungs." (Journal of American Medical Association, 2007) There are treatments for COPD and the first of which is: (1) Stop smoking: this is critically important for prevention of progression of COPD; (2) Bronchodilators: This is a medication taken by means of an inhaler that assists in opening the air passageways in the lung; (3) Corticosteroids: This is also medication taken by means of an inhaler to combat inflammation that occurs in the air pages and lungs; (4) Oxygen: helps with COPD in patients that have difficulty in taking in sufficient oxygen; and (5) Antibiotics: are helpful in fighting occurrence of infections of a bacterial nature that worsen the symptoms of COPD. (Journal of American Medical Association, 2007)

III. GOALS of TREATMENT in COPD

As stated in the previous section there are treatments for COPD and according to the National Heart, Lung and Blood Institute "quitting smoking is the single most important thing" that the individual can do in order to reduce the risk of the development of 'chronic obstructive pulmonary disease (COPD) and to slow the progression of the disease COPD. The goals of treatment for COPD are: (1) to relieve the symptoms with no to little side experience of side effects; (2) to slow the disease progression; (3) to improve the individual's tolerance for exercise; (4) prevention and treatment of complications or onset of problems occurring suddenly; and (5) to improve the individuals' health overall. (National Heart, Lung, and Blood Institute: Disease and Conditions Index, 2007) it is important to note that the National Heart, Lung, and Blood Institute relates that treatment of COPD is "different for each person" and that the individuals doctor might well refer the individual to a lung specialists or 'pulmonologist'. (2007) Treatment is based upon the severity of the symptoms experienced by the individual, which may be: (1) mild; (2) moderate; or (3) severe in nature.

IV. COPD MEDICATIONS

Medications prescribed for COPD, as related previously include the use of bronchodilators. The bronchodilators works through muscle relaxation of the muscles that surround the airways in opening up the airways fast resulting in making it easier to breathe. Bronchodilators are of two types: (1) short-acting; and (2) long-acting. (National Heart, Lung, and Blood Institute: Disease and Conditions Index, 2007) Bronchodilators that are short-acting have a duration of relief to the individual with COPD for approximately four to six hours and are used 'as needed' while long-acting bronchodilators last approximately twelve hours and are used each day to bring relief in breathing for the individual with COPD. The majority of bronchodilators are inhaled and travel directly to the lungs where the medication is needed. There are various types of inhalers and the individual with COPD should be sure that proper use of the inhaler is understood. The individual with mild COPD will generally receive recommendations from the doctor to use a short-acting bronchodilator 'as needed'. The individual with moderate to severe COPD will generally receive recommendations from the doctor to use one or more of the inhalers and generally, the recommendation of the doctor will be to use both a long- and short-acting inhaler, which is termed "combination therapy." (National Heart, Lung, and Blood Institute: Disease and Conditions Index, 2007) the following descriptions of medications used to treat COPD are stated by the National Heart, Lung, and Blood Institute: Disease and Conditions Index (2007:

Inhaled glucorticosteriods (steroids) are generally used by individuals with moderate or severe forms of COPD and are used for reduction of inflammation in the airways. Trial uses of these inhaled steroids are generally recommended for a period of six weeks up to three months in order to see if this medication helps the individual with problems in breathing;

Flu (influenza) can result in serious complications for the individual with COPD. Flu shots are stated to "reduce the change of getting the flu" and flu shots each year are recommended for the individual with COPD;

Pneumococcal Vaccine: Individuals with COPD should receive this vaccination for prevention of commonly caused pneumonia. It may be necessary for individuals older than 55 to receive vaccinations every five years;

Pulmonary Rehabilitation: This is a "coordinated program of exercise, disease management training, and counseling" (National Heart, Lung, and Blood Institute: Disease and Conditions Index, 2007) that assist the individual in living a more active life and in being able to fulfill their daily activities.

Each individual's pulmonary treatment program is of a personalized nature and is one, which is decided upon by the individual and their doctor and is likely to include: (1) exercise training; 2) nutrition advice; 3) education about the disease and management of the disease; and (4) counseling. (National Heart, Lung, and Blood Institute: Disease and Conditions Index, 2007) Different health care professionals managed different types of care for the COPD patient and may include:

Doctors;

Nurses

Physical Therapists;

Respiratory Therapists;

Exercise Therapists; and Dieticians. (National Heart, Lung, and Blood Institute: Disease and Conditions Index, 2007)

All of the above healthcare professionals work in combination and collaboration in the development and implementation of a program specialized to the severity, symptoms, and progression of COPD in the individual patient.

V. COMPONENTS of the PULMONARY REHAB PROGRAM

There are several components of the pulmonary rehab program that is inclusive of the following:

Medical evaluation and management;

Setting Goals;

Exercise Training;

Education;

Program Results or Outcomes;

Oxygen Treatment; and Surgery. (National Heart, Lung, and Blood Institute: Disease and Conditions Index, 2007)

VI. PREVENTION of PROGRESSION of COPD

Progression of COPD is, first and foremost, approached through addressing smoking cessation by the individual and this includes refraining from being with those who smoke and being in locations where smokers will be present. Secondly, it is important to keep away from other lung irritants to include: (1) pollution; (2) dust; (3) certain cooking or heating fumes; and (4) the outside air when air quality is rated as 'poor'.