Chronic Obstructive Pulmonary Disease (COPD) is the name for a group of conditions that occur due to permanent damage to the lungs and airways resulting in chronic obstruction of the airways. This obstruction limits airflow through the airways causing individuals with COPD to experience difficulty breathing. Common obstructions include bronchoconstriction, inflammation, and increased mucus production. Many individuals have emphysema, chronic bronchitis, or a combination of asthma, emphysema, and chronic bronchitis.
The primary cause of COPD is smoking, but their area a few cases in which COPD is caused by inhaling toxins. Though there is no cure for COPD, there are medications that can help individuals breathe easier.
Bronchodilators are medications that dilate the airways which allow air to flow easier, therefore, alleviating shortness of breath. Beta2-agonist bronchodilators stimulate beta2-receptors located on the smooth muscle of the bronchial airways, relaxing the muscles and resulting in bronchodilation. Beta2-agonist bronchodilators are referred to as rescue drugs and are used to provide quick relief of symptoms. Albuterol (Proventil, Ventolin) and Levalbuterol (Xopenex) are examples of short-acting beta2-agonist bronchodilators.
Anticholinergic bronchodilators are medications that block vagal tone and reflexes preventing bronchoconstriction. Anticholinergic bronchodilators do not directly dilate the airways but instead prevent them from constricting. Ipratropium Bromide (Atrovent) is an anticholinergic bronchodilator that is commonly used with a beta2-agonist bronchodilator such as Albuterol. Using a beta2-agonist and anticholinergic bronchodilator together can augment the duration of bronchodilation.
Corticosteroids are widely used in the treatment of asthma, COPD, and other respiratory diseases and are medications that reduce inflammation in the body and the lungs making airflow through the lungs easier. Corticosteroids are also referred to as anti-inflammatory drugs. Prednisone, Prednisolone, Hydrocortisone are common systemic corticosteroids.
Inhaled corticosteroids are used as preventive therapy in respiratory diseases due to its delayed onset of clinical effect. Inhaled corticosteroids do not have a rapid effect and therefore cannot be used in an acute attack or during an exacerbation. Inhaled corticosteroids do not generally produce systemic adverse effects until large doses are administered. Beclomethasone dipropionate, Fluticasone (Flovent), and Budesonide (Pulmicort) are commonly inhaled corticosteroids.
Bronchodilators and Corticosteroids are considered first-line medications for the treatment of COPD, however, these treatments alone don’t always help. Methylxanthines are often given when another treatment has failed to adequately control symptoms. Methylxanthines are medications that work like bronchodilators to affect the airways by relaxing the smooth muscle of the airway. Methylxanthines are also stimulated which stimulate heart rate and force of contraction. Theophylline and Aminophylline are common methylxanthines. Theophylline is given orally and aminophylline is administered intravenously.
Mucolytics are medications that reduce the viscosity of respiratory tract secretions thereby loosening the mucus and facilitating the removal of accumulated mucus from the airways. Acetylcysteine (mucomyst), Dornase Alfa (Pulmozyme), and Sodium Bicarbonate are examples of mucoactive agents.
It is important that Oxygen is given to maintain oxygen saturation levels greater than 92%. Although the administration of oxygen can cause an elevation in arterial carbon dioxide levels (PaCO2) in a few patients, this is far less of a problem than hypoxia itself. It is important to use the lowest FiO2 possible while ensuring adequate flow rates. High flow oxygen delivery devices such as a high flow nasal cannula or a venturi mask (air-entrainment mask) are the best device to use with patients experiencing an exacerbation. These devices are able to meet or exceed the patient’s inspiratory flow demands.
In your own words define the following vocabulary terms and provide responses to the questions below.
What does the term obstruction refer to when speaking about COPD
What is the mechanism of obstruction for bronchitis?
What is the mechanism of obstruction for emphysema?
What is the mechanism of obstruction for asthma?
What is the mechanism of obstruction for bronchiectasis?
Submit your answers in at least 500 words on a Word document. You must cite at least three references in the IWG format to defend and support your position.
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