Chronic obstructive pulmonary disease (COPD) is a progressive disease (gets worse over time) that makes it hard to breathe.
In COPD, less air flows in and out of the airways because air sacs lose their elasticity or become thick, inflamed, and make more mucus. The term "COPD" includes two main conditions: emphysema and chronic bronchitis. Most people who have COPD have both emphysema and chronic bronchitis.
Chronic bronchitis is a chronic inflammation of the air passages with airflow obstruction. It involves a long-term cough with mucus.
involves destruction of the lung tissue, specifically the alveoli.
The main symptoms include shortness of breath, cough, and large amounts of mucus. Symptoms often worsen over time and can limit the ability of the patient to do routine activities.
- Tobacco smoking is the most common cause of COPD. Most people who have COPD smoke or used to smoke.
- Air pollution, chemical fumes, or dust—also may contribute to COPD.
- Genetics plays a smaller role
The diagnosis is based on poor airflow as measured by lung function tests. In contrast to asthma, the airflow reduction does not improve significantly with the administration of medication. Most of the time, COPD is diagnosed in middle-aged or older adults. Approximately 12 million people in the United States have been diagnosed with COPD. Many more may be affected and not know they have it.
COPD can be prevented by reducing exposure to the known causes. This includes efforts to decrease rates of smoking and to improve indoor and outdoor air quality.
COPD treatments include:
2. Quitting smoking
- Bronchodilators: Short-acting bronchodilators include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex), and ipratropium (Atrovent). The long-acting bronchodilators include tiotropium (Spiriva), salmeterol (Serevent), formoterol (Foradil, Perforomist), arformoterol (Brovana), indacaterol (Arcapta) and aclidinium (Tudorza).
- Inhaled steroids like Fluticasone (Flovent) and budesonide (Pulmicort)
- Bronchodilators combined with inhaled steroids like: Salmeterol and fluticasone (Advair) and formoterol and budesonide (Symbicort)
- Oral steroids for moderate or severe COPD
- Phosphodiesterase-4 inhibitors: roflumilast (Daliresp). This drug decreases airway inflammation and relaxes the airways.
- Antibiotics: Antibiotics help fight acute exacerbations such as acute bronchitis, pneumonia and influenza
3. Staying active
4. Avoiding triggers
5. Oxygen therapy (if COPD gets worse)
6. Lung transplantation (rarely)