COPD
Chronic Obstructive Pulmonary Disease
external image healthy-vs-copd.jpg
Mia Tedone
May 18th, 2010


Abstract:

Chronic obstructive pulmonary disease is characterized by chronic emphysema, bronchitis or both. This condition worsens over time and is characterized by a blockage in the airways to your lungs. Breathing and basic activities become harder as your condition worsens. This disease is mainly caused by excessive smoking of tobacco products. Eighty to ninety percent of all cases of COPD are directly linked to smoking cigarettes. If you are a non-smoker, you may get COPD from second hand smoke, dust, air pollution or inherited from your family. I also researched the effects of antimicrobial therapy for COPD on patients in hospitals. There is some controversy over whether or not it is effective in helping patients.


Introduction:
I decided to do my research on Chronic Obstructive Pulmonary Disease because I knew little about it even though there are so many people living with it. It is the fourth highest killer disease in America and it is preventable. Smoking increases your chances of getting it drastically. If there was more awareness about the harmful effects of this disease and how debilitating it is, maybe less people would smoke. Thirty two million people suffer from COPD in the United States, and half of these are undiagnosed cases. The combination of chronic bronchitis and emphysema is a deadly one. Not only is it deadly, its also very unpleasant to have and researching it has solidified my decision to never smoke cigarettes.
external image facts_chart1.gif
Discussion
:
Chronic obtrusive pulmonary disease is a disease category that encompasses both emphysema and chronic bronchitis. These two are usually seen in combination, although one or the other may be more predominant. Both of these diseases allow less and less air to flow to the lungs and out of the lungs and over time these symptoms worsen.

Basic Facts
  • 12 million people are living with COPD and another 12 million are undiagnosed
  • It is the 4th leading cause of death in America with 126,129 deaths in 2003
  • Kills more women then men
  • A person dies from COPD every 4 minutes
  • COPD costs the US economy $32.1 billion a year
  • Approximately 600 million people are living with it worldwide
  • Does not have a cure, but is relatively easy to diagnose.

Emphysema Overview:
Someone with emphysema has destroyed walls of the bronchioles and alveoli. Because of this there is an abnormally enlarged airspace. There is a limited amount of airflow because of abnormalities of lung elastin. This is important in the walls and passages of the alveoli. These abnormalities cause collapse or narrowing of the airways which limits the amount of airflow out of the lung. This damage is irreversible. This disease develops because of the destruction of elastin in the lung. This occurs from an "imbalance between a lung protease called elastase, which breaks down elastin, and alpha-1-protease inhibitor, the substance which inhibits elastase." (US Department of Health and Human Services) In a normal person, the protease and anti protease do not allow abnormal amounts of elastin destruction to occur. In some people there is a genetic defect that causes a decrease in the alpha-1-portease inhibitor levels which ruins the balance between protease and its inhibitor. This genetically originating emphysema is very rare. More likely, it is caused by cigarette smoking. Tobacco stimulates excess release of protease from normal lung cells. Not only that, cigarette smoke also inactivates a lot of protease inhibitors which decreases the amount of antiprotease available.

external image emphysema.jpg
Chronic Bronchitis Overview:
This disease is characterized by excessive mucus secretion in the bronchial tree. This makes you have a chronic productive cough. A person has chronic bronchitis if cough and sputum are present on most days for about 3 months for two successive years or for six months during one year.
external image 17099.jpg
When someone has COPD the lungs are unable to fully do their job. The walls of airways become thickened and plugged with mucus. This disease is a very serious and a national health problem. The number of cases are rising and causing a lot of deaths. Not only is the disease fatal, its onset is also during ones most productive years and because it limits the ability to breath so much, people with COPD are often unable to work or do many normal, daily activities.

Symptoms:
Early
  • shortness of breath
  • slight morning cough
  • clear sputum
  • episodes of wheezing
Later
  • more pronounced shortness of breath
  • severe episodes of breathlessness occurring after only modest exertion
  • minor colds and infections are now very serious and take longer to recover from.
  • sleeping laying down becomes difficult so patients sleep in a semi seated position.
  • awaking in the night feeling like they need to sit up and cough.
COPD is also places a large burden on the heart. As the disease progresses, less and less oxygen is being put into the blood which causes important blod vessels in the lungs to constrict. The negative effects to the heart also contribute to problems in the liver, legs, ankles, and nervous system.

Treatment:
There is no cure for COPD but it is almost always preventable. Not smoking cigarrettes is the number one way to prevent the onset of this disease. No treatment has been shown to slow the disease progression and only oxygen therapy can increase survival rate. Some things a patient with COPD should do are:


  1. Quit smoking
  2. Avoid dusts, fumes, and air pollutions
  3. Stay away from people with colds and flu
  4. Avoid excessive temperatures or altitudes
  5. Stay hydrated- keeps sputum (phlegm) loose
  6. Eat healthy
  7. Avoid gas producing foods

Some medications prescribed:
  • Bronchodilators
  • Antibiotics- given at the first sign of respiratory infection
  • Corticosteroids- used when wheezing cannot be controlled
  • Expectorants
  • Diuretics
  • Digitalis- used to treat heart failure

"Guidelines Versus Clinical Practice in Antimicrobial Therapy for COPD"
-Joshua D. Farkas - Harold L. Manning
I read a study that was done by Joshua D. Farkas and Harold L. Manning about the use of antibiotics to treat COPD pneumonia cases. There are certain guidelines doctors should follow before giving a patient antibiotics, but this does not always occur. In this study the discovered that doctors often deviated from the antibiotic guidelines and would prescribe antibiotics more often then possibly necessary just in case. This is controversial because doctors should be following the guidelines since overuse of antibiotics causes bacteria to mutate.

Conclusion:
Overall Chronic Obstructive Pulmonary Disease is a very serious issue in America and around the world. It is the fourth highest cause of death and is easily preventable by simply not smoking cigarrettes. If more people were aware of COPD and its effects and risks, they would not be as likely to smoke. This disease makes everything about your life more difficult from sleeping to working to simply walking around your house. It is a serious medical problem without a cure and should be taken very seriously.

Literature Cited :

"COPD Foundation." COPD Foundation. N.p., n.d. Web. 18 May 2010. <http://www.copdfoundation.org/>.
Chronic Obstructive Pulmonary Disease. Unknown: US Department of Health and Human Services, 1986. Print.
Farkas, Joshua D. , and Harold L. Manning. "Guidelines Versus Clinical Practice in Antimicrobial Therapy for COPD." Springer Science and Business Media 1 (2010): 1-6. Print.
"What is chronic obstructive pulmonary disease (COPD)?." National Heart, Lung and Blood Institute. N.p., n.d. Web. 18 May 2010. <http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html>.