CHRONIC Symptoms of CODP include sputum production,

CHRONIC
OBSTRUCTIVE PULMONARY DISEASE

                                     

               Chronic obstructive pulmonary
disease (COPD) is a term used to describe chronic lung issues including
emphysema, chronic bronchitis, refractory asthma, etc. This condition is
distinguished by the patient loosing his or her breath. Symptoms of CODP
include sputum production, chronic coughing, wheezing, and severe inability to
breath. One of the first few signs of COPD are chronic cough and sputum
production, which shows that they are at risk of developing airflow obstruction
and shortness of breath. According to the World Health Organization, the 4th
leading cause of death worldwide was caused by COPD in 2006. It is a fatal
disease that caused almost 3 million deaths in several countries including
Canada, Japan, China, Brazil, Great Britain, and France.

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               The most important risk factor
for COPD is smoking cigarettes. The use of pipes, cigar, and other types of
tobacco products can increase the risk of COPD. Other risk factors that have
been identified are the exposure to occupations chemicals and dusts, recurrent
lung infections, low birth weight, airway hyper-responsiveness, and
socioeconomic factors. 

               COPD is described by chronic
inflammation of the airways, lung tissues, and pulmonary vasculature. With this
inflammation, several immune cells of the body are increased in the lungs
including macrophages, neutrophils, and lymphocytes. Regardless of the chronic
lung disease predominating in the patient, the end result is that progressive
airflow obstruction leads to hypoxia. Hypoxia is a deficiency in the amount of
oxygen that is reaching the tissues. When the lung tissues are not getting
enough oxygen from all the barriers, the patient will experience difficulty in
breathing causing them to cough and have mucus production. Symptoms from the
various lung diseases include barrel chest, cyanosis, and clubbing.

               Several classes of medications
are used to alleviate the symptoms of COPD, although they have not been proved
to reduce the long-term decline in the function of the lungs. Medications
commonly used to alleviate the symptoms include beta-adrenergic agonists,
anticholinergics, corticosteroids, methylxanthines, or a combination of more
than one of these drugs together. The goal of these medications is to dilate
the bronchioles to relieve bronchospasm, reduce obstruction in the airways, and
to improve the alveolar ventilation. Oxygen delivery is also considered a
prescription therapy, and is to be administered with great caution. In advanced
COPD, oxygen therapy for more than 15 hours each day has been shown to increase
the patient’s quality of life and survival.

               On discharge, the patient and
family requires considerable education regarding the disease and how to manage
it. Patients do well in a climate with minimal shifts in temperature and
humidity, and no extreme temperatures of hot and cold. The patient and family
can be taught to avoid environmental and occupational irritants, how to use the
respiratory devices, and how to correctly use oxygen delivery systems. In
addition, the patient can be instructed to have good nutrition, to avoid excess
weight gain or loss, and to avoid substances such as nicotine, alcohol, and
drugs.

               I have a patient who has history
of COPD due to long-term smoking for 25 years. As pharmacotherapy, she has been
prescribed albuterol 2.5mg and ipratropium bromide. During discharge, the patient
and family members were educated on smoking cessation and how to manage her
COPD.

Summary

               COPD is characterized by
progressive airflow obstruction that cannot be fully reversed. The limitations
in airflow are associated with inflammation of the lungs to noxious gases. The
main cause of COPD is smoking and the use of tobacco products. The patient and
family should be taught on how to manage and treat COPD, such as teaching them
to avoid environmental irritants and the importance of discontinuing smoking.