Emphysema
What are the treatments for the disease?
WHO has identified four components for management of emphysema. These include the following:
Assess and monitor the disease.
Reduce the person's risk factors.
Manage stable emphysema.
Manage exacerbations, or episodes where symptoms are worse.
Assessment and monitoring
Assessment and monitoring of the disease incorporates the following steps:
Identify people at risk for emphysema, even if they don't have symptoms.
Perform lung function tests to measure airflow limitations.
Do a medical history and physical exam to evaluate symptoms.
Reducing risk factors
Reducing the person's risk factors includes the following measures:
Avoid vigorous outdoor exercise when air quality is poor.
Stop smoking, if the person smokes.
Limit exposure to secondhand smoke.
Reduce occupational dusts and chemicals.
Eliminate sources of indoor pollution, such as wood burning stoves.
Managing stable emphysema
Management of stable emphysema includes the following:
Learn to identify and avoid risk factors.
Learn to identify problems and seek appropriate treatment.
Take medications as directed.
WHO recommendations for management of emphysema are broken down by the severity of the disease. Following are the recommendations for Stage 0 emphysema:
Get a flu vaccine once or twice a year.
Use antibiotics only for bacterial infections, but not for emphysema itself.
Identify and eliminate risk factors.
Recommendations for Stage I emphysema are the same as those for Stage 0. In addition, people with Stage I emphysema 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 for Stage II emphysema include the recommendations from Stage I. The following additional measures are recommended for times when symptoms are present.
Use long-acting bronchodilators on a regular basis.
Use inhaled glucocorticosteroids in cases of significant cough or shortness of breath.
Participate in a pulmonary rehabilitation program that uses teaching and exercise to improve lung function.
WHO recommendations for Stage III emphysema are as follows:
Use long-acting bronchodilators regularly.
Take short-acting bronchodilators as needed.
Seek treatment for complications, such as pneumonia.
Participate in a pulmonary rehabilitation program.
Use oxygen as needed
Discuss surgical options with the healthcare provider.
Managing worsening symptoms.
People with emphysema 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. Following are WHO guidelines for management of exacerbations.
Increase the dose and/or frequency of inhaled bronchodilators.
Take oral glucocorticosteroids to decrease airway swelling.
Take antibiotics for bacterial infection.
Take oxygen by mask or cannula.
Use a ventilator, or artificial breathing machine.
If a person has alpha-1-antitrypsin deficiency, or is a carrier, it is absolutely critical to avoid smoking. Intravenous replacement of the enzyme helps some people, but it is quite expensive.
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 glucose, and osteoporosis. Antibiotics can cause rash, stomach upset, and allergic reaction.
What happens after treatment for the disease?
Early diagnosis of emphysema 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 emphysema.
How is the disease monitored?
Emphysema 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.
|
Previous section
