What is Chronic Obstructive Pulmonary Disease (COPD) ?

Chronic obstructive pulmonary disease (COPD) is a respiratory problem characterised by persistent respiratory symptoms like breathlessness, chronic cough and sputum production. Its mainly seen in smokers after the age of 40 years but these symptoms may be underreported by the patients. COPD is currently the fourth leading cause of death worldwide and is expected to be the third leading cause of death by 2020. During the course of the disease patient may experience worsening of the respiratory problems and this is termed as exacerbation.

Causes:

1. Smoking
2. Indoor air pollution like exposure to biomass fuel
3. Outdoor air pollution
4. Occupational exposure to noxious fumes
pathology-of-copd5. Post infections like tuberculosis
6. Chronic uncontrolled asthma
7. Genetic factors

Diagnosis

Besides clinical symptoms of breathlessness, chronic cough and sputum production, there may be finding of barrel shaped chest and wheezing on auscultation.

The other major test which is required to ascertain the diagnosis as well stage COPD is spirometry or lung function tests in which the patient is asked to blow out air into the machine which measures the lung functions. Other ancillary investigations which your clinician may advise are chest x ray, ECG, CBC, lipid profile and in some cases CT chest.

Complications

COPD is a disease which is not confined to respiratory system but it affects almost all major organs. Concomitant diseases associated with COPD may be
1. Cardiovascular dysfunction
2. Skeletal muscle dysfunction
3. Osteoporosis
4. Depression
5. Anxiety
6. Metabolic syndrome
7. Lung cancer

Treatment

Smoking cessation: Complete cessation of smoking remains the cornerstone of treatment of copd.
Pulmonary rehabilitation: Regular physiotherapy and exercise to strengthen the respiratory muscles has proven to beneficial not only for the primary disease of COPD but also for the management of associated complications

Drugs

1. LAMA(long acting anti muscarinic agents): These are the drugs like tiotropium which your clinician may advise in form inhalers.

2. LABA(Long acting beta agonists): Drugs like formeterol, salmeterol are advised in form inhalers

3. Inhaled corticosteroids: Advised in combination with LABA in higher stages of COPD.

4. Methylxanthines : have modest bronchodilator effect

5. Phosphodiesterase inhibitors like roflumilast

Vaccination

Influenza and pneumococcal vaccine are recommended for COPD patients to reduce the incidence of pneumonia.


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