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Pathophysiology
Chronic Obstructive Pulmonary Disease (COPD) is a disease that affects the lungs and leads to massive inflammation of the tissues that make up the lungs (Barnes, 2000). Generally, this disease condition results in the blockage of the air passages in the pulmonary compartments. It has been noted that the major cause of this disease is chronic cigarette smoking. However, smoke that comes from other sources is also associated with the development of this disease (Gross, 2003). It has been defined that the disease mainly occurs in coal mines, cotton ginneries, and grain stores.
It has been noted that smoke and dust or other irritants make blood cells (neutrophils and T-lymphocytes) accumulate and cause blockages in the pulmonary airways (Copstead & Banasik, 2009). An inflammatory response is triggered by this phenomenon. In this attempt, an influx of inflammatory mediators moves into these sites to destroy the inhaled debris. Repeated exposure to such irritants triggers the inflammatory response which seems to progress. This leads to the massive destruction of the airways. They narrow and constrict a condition that leads to excessive mucus production which reduces the functioning of the cilia. This makes clearance of the airways difficult, and patients develop persistent coughs and general dyspnea (Gross, 2003). The mucus layer that forms on the airways creates an attractive environment for bacteria that live and multiply in a warm and moist setting. Such bacteria colonize the region and increase in number which results in the development of diverticula and bacterial infection (Copstead & Banasik, 2009).
Treatment
Upon diagnosis of a patient with COPD, special attention should be given to the reduction of the risk factors and amelioration of signs and symptoms through pharmacological and non-pharmacological procedures to optimize the patients functional status and longevity. Focus on risk reduction helps to control the induced inflammatory reactions that continuously damage the airways. This is the first step in managing and treating COPD. Smoking cessation plays a great role in the cure of this disease.
The use of bronchodilators also makes up a basis in the treatment of COPD (Gross, 2003). Some of the most commonly used types include anticholinergics, beta-adrenergic agonists, and methylxanthines (Barnes, 2000). These bronchodilators cause smooth muscle relaxation which enhances effective lung deflation. It also helps to minimize dynamic hyperinflation. Improved thoracic exercise enhances inspiration capacity and helps to remove mucus exudates from the airways. Bronchodilators, therefore, enhance the capacity of regular exercises in COPD patients and consequently improve their condition.
Phosphodiesterase-4 inhibitors are also widely used to fight against COPD. These have been shown to improve the condition by stable exacerbations. The use of corticosteroids has helped as well to cure and improve conditions of COPD patients. It has been observed that inhaled corticosteroids are effective in managing exacerbations (Gross, 2003). Prophylactic immunizations against influenza have been made available to people and have been associated with reduced incidences of COPD (CDC, 1999). It has been recommended that the 23-polyvalent pneumococcal vaccine should be administered to patients with COPD. Antibiotics such as macrolides are effective in fighting bacterial colonies which inhabit the airways. They, therefore, have found expansive applicability in COPD treatment plans. Mucokinetic agents together with corticosteroids have also been used to reduce the levels of exacerbations and auger in the management of COPD (Barnes, 2000).
In conclusion, it should be stated that priority in treating COPD has to be given to the change of lifestyle by avoidance of the irritants that trigger an inflammatory response. It is vital to avoid smoking and dust in the workplace.
References
Barnes, J. (2000). Chronic Obstructive Pulmonary Disease. N Engl J Med, 343(4), 269-80.
Centers for Disease Control and Prevention (CDC). (1999). Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep, 48, 1-28.
Copstead, C., & Banasik, L. (2009). Pathophysiology. St. Louis: Saunders.
Gross, N. J. (2003). Outcome Measures in COPD. Are We Schizophrenic? Chest, 123(5), 1325-1327.
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