• Clinical Indications Overview
• Asthma
• COPD
• Cystic Fibrosis
• Eczema

Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease and an umbrella term for a group of respiratory tract diseases that are characterized by airflow obstruction or limitation. The most common cause of COPD is tobacco smoking, but COPD can also be caused by exposure to other airway irritants like coal dust or solvents. Conditions included in this umbrella term: chronic bronchitis, emphysema, and bronchiectasis.   

COPD is a disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with abnormal inflammatory response of the lungs to noxious particles or gases. Early symptoms of COPD include shortness of breath, recurrent respiratory infections and morning cough. As the disease continues, the symptoms are seen with increased frequency and severity, including severe cough, constant wheezing, the development of thick mucous secretions and recurrent inflammation in the airways, leading to respiratory failure and death.  

COPD is not curable. Medicines are most often used to control symptoms or to reverse acute exacerbations. COPD in all forms typically progresses if the patient continues to smoke. Therefore, smoking cessation is one of the most important factors in slowing down the progression of COPD.

The pathophysiology of lung disease in COPD is characterized by a repetitive cycle that begins with obstructed airways that inevitably leads to inflamed airways often accompanied by chronic infection, which if left untreated causes significant progressive loss of lung function. Although elimination of exogenous exposure of environmental toxins and smoking cessation will prevent accelerated and further deterioration, lung function loss is largely irreversible.  

Current standard of care therapies in COPD are used both intermittently and chronically to improve symptoms by dilating the bronchials, reducing inflammation and treating recurrent infections. The goal of intervention is to retard disease progression by maintaining or improving pulmonary function, increase time between pulmonary exacerbations and reduce the severity of pulmonary exacerbations. The use of brohchodilators, nebulizers, and corticosteroids has been shown to be effective. Patients with chronic disease and significant lung function impairment (FEV1 < 50% predicted) may also benefit from the regular use of inhaled steroids. Oxygen therapy is the only current medical intervention that is proven to prolong the lives of patients with this disease process. Oxygen is only indicated in patients with severe hypoxia documented by a physician; however, oxygen should be administered with caution to patients with COPD due to a risk of carbon dioxide retention. Surgical management includes single or double lung transplant, and lung volume reduction surgery (LVRS), which is currently being evaluated in a large, national trial in the UK. Most moderate and severe patients with COPD should be considered for pulmonary rehabilitation.

If you would like to learn more about COPD, talk with your physician and visit the following websites:
American Lung Association (www.lungusa.org)
Gold Initiative (www.goldcopd.com)