What exactly is chronic obstructive pulmonary disease (COPD)? COPD refers to a syndrome of respiratory ailments; specifically, chronic bronchitis and emphysema. Asthma, another respiratory disease, is classified as a restrictive, verses, obstructive. However, asthma can have some overlap of with COPD, and is considered to be COPD, only if the obstructive airflow is unremitting, and irreversible.
While chronic bronchitis and emphysema are closely related to nicotine smoke, either direct or second-hand, asthma is not. However, if an asthmatic is smoking or around second-hand smoke, their symptoms are more likely to overlap with COPD.
COPD Common SymptomsCommon symptoms of COPD include:
- obstructive airflow: It is difficult to exhale.
- cough, which may be dry at times, but is usually productive
- wheezing, usually with exhalation
- shortness of breath, typically on exertion
What are Chronic Bronchitis and Emphysema?
Chronic Bronchitis is defined in clinical terms as a condition in which chronic productive cough is present for a least three months per year for at least two consecutive years. The definition specifies further that other causes of chronic cough (for example, gastroesophageal reflux, asthma, and postnasal drip) have been ruled out.
Emphysema is defined in anatomical terms as a condition characterized by abnormal, permanent enlargement of the airspaces beyond the terminal bronchiole, accompanied by destruction of the walls of the airpaces without fibrosis.
How to Treat COPD
Although the airflow obstruction from emphysema itself is irreversible, most patients do show a reversible component of airflow obstruction, when tested after bronchodilater treatment.
Another treatment option to optimize lung function is administering steroids, such as Prednisone.
As the COPD progresses to end-stage or level lll, supplemental oxygen is typically added to the treatment course. However, oxygen is a bronchodilator, and is also used in treating patients with moderate COPD.
One of the very obvious ways to "treat" COPD, is to remove all nicotine smoke, either direct, or second-hand from the patient. This is easier said than done, and some patients, even on oxygen will continue to smoke.
Pulmonary Rehabilitation For the COPD Patient.
At any stage of COPD, if the patient is stable, pulmonary rehabilitation is a priority for maximizing functional status. Pulmonary rehabilitation is an educational based program, which designs a plan of care, as well as a progressive exercise class for each individual, based on clinical assessments.
This education may be renewing a patient's ability to perform daily activities, as well as gradually add enjoyable past times, to enhance quality of life. The exercise program will enhance exercise capacity.
Progressive exercise programs should emphasize upper body strength. Strengthening the muscles of the shoulder girdle, can enhance ventilatory function.
Reference: Seventh Edition
Egan’s Fundamentals of Respiratory Care -
