Continued from issue #133.
5-7 November, Page 15

RISK FACTORS

Smoking is the main risk factor. It’s responsible for almost all the cases of COPD.

Other risk factors for COPD are:

Exposure to certain gases or fumes in the workplace

Exposure to heavy amounts of secondhand smoke and pollution

Rare genetic disorders

COPD SYMPTOMS — COPD

COPD usually causes no or mild symptoms at first. As the disease progresses, symptoms usually worsen. The most common symptoms include:

Coughing and spitting up phlegm

Wheezing (a whistling or squeaking noise as you breathe)

Shortness of breath with activity or even at rest

DIAGNOSIS:

Pulmonary function tests (PFTs) — The pulmonary function test (PFT) that measures airway obstruction is called spirometry, and is the best test for diagnosing COPD. Spirometry can detect COPD even in people who do not yet have symptoms.

After the diagnosis of COPD is confirmed, spirometry is repeated over time to monitor the status of the disease and the effectiveness of treatment.

Using a stethoscope to listen to the lungs can also be helpful. However, sometimes the lungs sound normal even when COPD is present.

Pictures of the lungs (such as x-rays and CT scans) can be helpful, but sometimes look normal even when a person has COPD (especially chest x-ray).

Sometimes patients need to have a blood test (called arterial blood gas) to measure the amounts of oxygen and carbon dioxide in the blood.

COPD TREATMENT — The first and most important part of any treatment plan for COPD is for smokers to stop smoking. This is true regardless of how long ago you were diagnosed with COPD and how severe your disease is. Studies of people with COPD show that worsening of the disease is slowed in people who stop smoking.

Currently, there is no cure for COPD; however, many treatments are available for the symptoms and complications of this disorder. Most patients require ongoing treatment to keep symptoms under control.

MEDICATIONS

Bronchodilators — Medications that help open the airways, called bronchodilators, are a mainstay of treatment for chronic obstructive pulmonary disease. Bronchodilators help to keep airways open and possibly decrease secretions. They are most commonly given in an inhaled form using a metered dose inhaler (MDI), dry powder inhaler (DPI), or nebulizer.

Glucocorticoids — Glucocorticoids (also called steroids, although they are very different from muscle building steroids) are a class of medication that has anti-inflammatory properties. Glucocorticoids can be taken with an inhaler, as a pill, or as an injection. Inhaled glucocorticoids may be recommended if your symptoms are not completely controlled with bronchodilators and/or if you have frequent flares of chronic obstructive pulmonary disease.

Glucocorticoids taken in pill form are sometimes used for short term treatment (eg, for flares of COPD), but are not generally used long-term because of the risk of side effects.

Oxygen — People with advanced chronic obstructive pulmonary disease can have low oxygen levels in the blood. This condition, known as hypoxemia, can occur even if the person does not feel short of breath or have other symptoms. The oxygen level can be measured with a device placed on the finger (pulse oximeter) or with a blood test (arterial blood gas). People with hypoxemia may be placed on oxygen therapy, which can improve survival and quality of life.

Antibiotics – Antibiotics are prescribed during symptom flare-ups, because infections can make COPD worse.