Chronic Obstructive Pulmonary Disease
Alternate Names : COPD, Chronic Obstructive Lung Disease (COLD)
What are the treatments for the disease?
WHO has identified the following four components for management of COPD:
assessing and monitoring the disease
reducing the person's risk factors
managing stable COPD
managing exacerbations, or episodes where symptoms are worse
Assessment and monitoring
Assessment and monitoring of the disease incorporates the following steps:
identification of people at risk for COPD, even if they don't have symptoms
performing lung function tests to measure airflow limitations
doing a medical history and physical exam to evaluate symptoms
Reducing risk factors
Reducing the person's risk factors includes the following measures:
avoiding vigorous outdoor exercise when air quality is poor
smoking cessation, if the person smokes
limiting exposure to secondhand smoke
reducing occupational dusts and chemicals
eliminating sources of indoor pollution, such as wood-burning stoves
Managing stable COPD
Management of stable COPD includes the following:
learning to identify and avoid risk factors
learning to identify problems and seek appropriate treatment
taking medications as directed
WHO recommendations for management of COPD are broken down by the severity of the disease. Following are recommendations for Stage 0 COPD:
getting a flu vaccine once or twice a year
using antibiotics only for bacterial infections, but not for COPD itself
identifying and eliminating risk factors
Recommendations for Stage I COPD are the same as those for Stage 0. In addition, people with Stage I COPD should use short-acting bronchodilators as needed. Bronchodilators relieve cough and shortness of breath by opening the airways. In general, WHO recommends inhaled bronchodilators rather than oral medications.
Recommendations of Stage II COPD include the recommendations from Stage I. Additional measures are recommended for times when symptoms are present, including the following:
using long-acting bronchodilators on a regular basis
using inhaled glucocorticosteroids, for people with significant cough or shortness of breath
participating in a pulmonary rehabilitation program, which uses teaching and exercise to improve lung function
WHO gives the following recommendations for Stage III COPD:
using long-acting bronchodilators regularly
taking short-acting bronchodilators as needed
seeking treatment for complications, such as pneumonia
participating in a pulmonary rehabilitation program
using oxygen as needed
discussing surgical options with the healthcare provider
Managing exacerbations
People with COPD may have worsening, or exacerbation, of symptoms when they develop a respiratory infection. Symptoms may also be worsened by cigarette smoke, as well as other factors. WHO guidelines for management of exacerbations include the following:
increasing the dose and/or frequency of inhaled bronchodilators
taking oral glucocorticosteroids to decrease airway swelling
taking antibiotics for bacterial infection
taking oxygen by mask or cannula
being on a ventilator, or artificial breathing machine
What are the side effects of the treatments?
Bronchodilators may cause an increased heart rate and blood pressure. Oral glucocorticosteroids can cause increased risk for infection, high blood sugar, and osteoporosis. Antibiotics can cause rash, stomach upset, and allergic reaction.
What happens after treatment for the disease?
Early diagnosis of COPD and effective treatment can slow its progression. People who eliminate risk factors and follow treatment guidelines have better outcomes. Those who continue to smoke may be increasingly disabled by breathing problems and complications of COPD.
How is the disease monitored?
COPD is monitored through regular visits with the healthcare provider. Lung function tests can be used to monitor limitations in airflow. Any new or worsening symptoms should be reported to the healthcare provider.
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