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You are here : 3-RX.com > Medical Encyclopedia > Diseases and Conditions > Chronic Obstructive Pulmonary Disease: Treatment & Monitoring
      Category : Health Centers > Respiratory System (Lungs and Breathing)

Chronic Obstructive Pulmonary Disease

Alternate Names : COPD, Chronic Obstructive Lung Disease (COLD)

Chronic Obstructive Pulmonary Disease | Symptoms & Signs | Diagnosis & Tests | Prevention & Expectations | Treatment & Monitoring

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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    Chronic Obstructive Pulmonary Disease: Prevention & Expectations

     

    Author: Rebecca Bascom, MD
    Reviewer: Eileen McLaughlin, RN, BSN
    Date Reviewed: 09/24/01



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