Chronic Obstructive Pulmonary Disease

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Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction and affects approximately 15 million people in the United States. COPD is associated with a high degree of morbidity and mortality, ranking as the fourth leading cause of death and third leading cause of hospitalization in the U.S
Chronic obstructive pulmonary disease (COPD) is a term referring to two lung diseases, chronic bronchitis and emphysema, that are characterized by obstruction to airflow that interferes with normal breathing. Both of these conditions frequently co-exist, hence physicians prefer the term COPD. It does not include other obstructive diseases such as asthma.
Smoking is the primary risk factor for COPD,Approximately 80 to 90 percent of COPD deaths are caused by smoking. Female smokers are nearly 13 times as likely to die from COPD as women who have never smoked. Male smokers are nearly 12 times as likely to die from COPD as men who have never smoked
Occupational exposure to certain industrial pollutants also increases the risk for COPD
COPD Treatment
Emphysema and chronic bronchitis often co-exist in COPD. The quality of life for a person suffering from COPD diminishes as the disease progresses. At the onset, there is minimal shortness of breath. People with COPD may eventually require supplemental oxygen and may have to rely on mechanical respiratory assistance.
Aggressive treatment efforts can and should be employed in the early stages of COPD. Smoking cessation is the single most effective – and cost effective – intervention to reduce the risk of developing COPD and slow its progression.
COPD lung damage is irreversible, but there are treatments that can improve a patient’s quality of life. Pharmacologic treatment can improve and prevent symptoms, reduce the frequency and severity of exacerbations, improve health status, and improve the ability to exercise.
Bronchodilator medications (prescription drugs that relax and open air passages in the lungs) are central to the symptomatic management of COPD. They can be inhaled as aerosol sprays or taken orally.
Inhaled or oral steroids are used to help decrease inflammation in the airways in some people. Antibiotics are often used to treat infections. Expectorants are sometimes used to help clear mucus from the airways.
The efficacy of inhaled glucocorticosteroids in modifying long-term decline in lung function continues to be under study, however short-term benefit has been demonstrated. Corticosteroids have been shown to decrease cardiovascular and lung cancer deaths and the frequency of exacerbations. Chronic treatment with systemic steroids involves the risk of serious side effects; therefore these are used mostly for acute exacerbations.
Use of inhaled steroids has been shown to increase the risk of pneumonia among those with COPD.
If children are diagnosed as AAT-deficient through blood screening, they may undergo a liver transplant.
A second treatment alternative is administration of the missing AAT pro¬tein. AAT re¬placement therapy is costly however, and it must be given intrave¬nous¬ly, on a weekly basis, for life. Its long-term effects are still being studied.
Non-pharmacologic treatment such as pulmonary rehabilitation, oxygen therapy, and surgical interventions can improve a person’s quality of life. One factor that can help protect against COPD development or its progression is physical activity, which can help slow lung function decline.
Pulmonary rehabilitation is a preventive health-care program provided by a team of health professionals to help people cope physically, psychologically, and socially with COPD
Source: American lung association USA

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