मंगलवार, 26 जनवरी 2010

COPD (chronic obstructive pulmonary disease)

DESCRIPTION OF COPD

COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time. Chronic obstructive pulmonary disease (COPD), also called chronic obstructive lung disease, is a term that is used for two closely related diseases of the respiratory system: chronic bronchitis and emphysema. In many patients these diseases occur together, although there may be more symptoms of one than the other. Most patients with these diseases have a long history of heavy cigarette smoking.
Chronic obstructive pulmonary disease (COPD) is a lung disease in which the lung is damaged, making it hard to breathe. In COPD, the airways - the tubes that carry air in and out of your lungs - are partly obstructed, making it difficult to get air in and out.
Other Names for COPD
• Chronic obstructive airway disease
• Chronic obstructive bronchitis
• Chronic obstructive lung disease
• Emphysema


SIGN & SYMPTOMS

COPD symptoms usually slowly worsen over time. At first, if symptoms are mild, you may not notice them, or you may adjust your lifestyle to make breathing easier. For example, you may take the elevator instead of the stairs. How severe your symptoms are depends on how much lung damage you have. If you keep smoking, the damage will occur faster than if you stop smoking. In severe COPD, you may have other symptoms, such as weight loss and lower muscle endurance. Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions. Your doctor can determine if you have COPD. If you have COPD, you may have frequent colds or flu. If your COPD is severe, you may have swelling in your ankles, feet, or legs; a bluish color on your lips due to low levels of oxygen in your blood; and shortness of breath. Over time, symptoms may become bad enough to see a doctor. For example, you may get short of breath during physical exertion.
The signs and symptoms of COPD include:
• An ongoing cough or a cough that produces large amounts of mucus (often called "smoker's cough")
• Shortness of breath, especially with physical activity
• Wheezing (a whistling or squeaky sound when you breathe)
• Chest tightness
These symptoms often occur years before the flow of air into and out of the lungs declines. However, not everyone who has these symptoms has COPD. Likewise, not everyone who has COPD has these symptoms. Some severe symptoms may require treatment in a hospital. You—with the help of family members or friends, if you're unable—should seek emergency care if:
• You're having a hard time catching your breath or talking.
• Your lips or fingernails turn blue or gray. (This is a sign of a low oxygen level in your blood.)
• You're not mentally alert.
• Your heartbeat is very fast.
• The recommended treatment for symptoms that are getting worse isn't working.


RISK FACTOR

Long-term exposure to other lung irritants also is a risk factor for COPD. Examples of other lung irritants include air pollution and chemical fumes and dust from the environment or workplace. The main risk factor for COPD is smoking. Most people who have COPD smoke or used to smoke. People who have a family history of COPD are more likely to get the disease if they smoke. Most people who have COPD are at least 40 years old when symptoms begin. Although it isn't common, people younger than 40 can have COPD. For example, this may happen if a person has alpha-1 antitrypsin deficiency, a genetic condition. Risk factors for COPD are factors that do not seem to be a direct cause of the disease, but seem to be associated in some way. Having a risk factor for COPD makes the chances of getting a condition higher but does not always lead to COPD. Also, the absence of any risk factors or having a protective factor does not necessarily guard you against getting COPD. For general information and a list of risk factors
The list of risk factors mentioned for COPD in various sources includes:
• Cigarette smoking - the major risk
• Heredity
• Occupation pollution exposure
• Environmental air pollution
• History of childhood respiratory infections
• Low socioeconomic status

ACTION/ ITEMS TO REDUCE EXPOSE

Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program. The National Heart, Lung, and Blood . You can take steps to prevent COPD before it starts. If you already have COPD, you can take steps to prevent complications and slow the progress of the disease.
The best way to prevent COPD is to not start smoking or to quit smoking before you develop the disease. Smoking is the leading cause of COPD. Also, try to avoid secondhand smoke and other lung irritants that can contribute to COPD, such as air pollution, chemical fumes, and dust. Follow your treatments for COPD exactly as your doctor prescribes. They can help you breathe easier, stay more active, and avoid or manage severe symptoms. Talk with your doctor about whether and when you should get flu and pneumonia vaccines. These vaccines can lower your chances of getting these illnesses, which are major health risks for people who have COPD. COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD.
• COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.
• COPD has no cure yet. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.
• Quitting smoking is the most important step you can take to treat COPD. Other treatments include medicines, vaccines, pulmonary rehabilitation, oxygen therapy, surgery, and managing complications. Many programs are available to help smokers quit smoking and to stay off tobacco. Some programs are based on behavior modification techniques; others combine these methods with nicotine gum or nicotine patches as aids to help smokers gradually overcome their dependence on nicotine.
• You can take steps to prevent COPD before it starts. Also, try to avoid other lung irritants that can contribute to COPD.
• If you have COPD, you can take steps to manage your symptoms and slow the progress of the disease. Quit smoking and try to avoid other lung irritants. Also, get ongoing care, manage the disease and its symptoms, and prepare for emergencies.
• Avoid air pollution, including cigarette smoke, and curtail physical activities during air pollution alerts.
• Refrain from intimate contact with people who have respiratory infections such as colds or the flu and get a one-time pneumonia vaccination (polyvalent pneumococcal vaccination) and yearly influenza shots.
• Drink a lot of fluids. This is a good way to keep sputum loose so that it can be brought up by coughing.
• Maintain good nutrition. Usually a high protein diet, taken as many small feedings, is recommended.
• Consider "allergy shots." COPD patients often also have allergies or asthma which complicate COPD.

TREATMENT

If you have COPD, knowing when and where to seek help for your symptoms is important. You should seek emergency care if you have severe symptoms, such as trouble catching your breath or talking. If you have COPD, it's important to get ongoing medical care. Take all of your medicines as your doctor prescribes. Make sure to refill your prescriptions before they run out. Bring all of the medicines you're taking when you have medical checkups.
Talk with your doctor about whether and when you should get flu and pneumonia vaccines. Also, ask him or her about other diseases for which COPD may increase your risk, such as heart disease, lung cancer, and pneumonia. Keep your windows closed and stay at home (if possible) when there's a lot of air pollution or dust outside. If you smoke, quit. Smoking is the leading cause of COPD. Talk to your doctor about programs and products that can help you quit. Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program. The National Heart, Lung, and Blood. Try to avoid secondhand smoke and other lung irritants that can contribute to COPD, such as air pollution, chemical fumes, and dust. Keep these irritants out of your home. If your home is painted or sprayed for insects, have it done when you can stay away for awhile. You can do things to help manage your disease and its symptoms.
The list of treatments mentioned in various sources for COPD includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
• Quit smoking
• Bronchodilators
• Sympathomimetics - inhaled, injected, or taken orally.
• Methylxanthines - intravenously, orally, or rectally.
• Theophylline derivatives
• Corticosteroids or steroids - reduce airway swelling and inflammation.
• Antibiotics - against lung infections.
• Trimethoprim-sulfamethoxazole combinations
• Expectorants - loosen mucus
• Diuretics - usually for patients with right-heart failure; diuretics get rid of body fluid reducing the risk of fluid in the lungs.
• Digitalis (digoxin) - improves the heart-beat, but can be a risky drug to take.
• Cough suppressants - e.g. codeine
• Pulmonary rehabilitation programs
• Intermittent mechanical ventilatory support
• Treatments for clearance and drainage of airway passages
• Drink fluids - helps the mucus have enough fluid to drain.
• Avoid conditions that exacerbate symptoms
• Quit smoking - by far the most important action.
• Avoid cigarette smoke
• Avoid flying in aeroplanes - many COPD patients need oxygen to fly.
• Avoid excessive heat
• Avoid excessive cold
• Avoid very high altitudes
• Allergy shots
• Control allergies or asthma

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