COPD, or chronic obstructive

pulmonary disease
 hat is COPD?

‡ is a progressive disease that makes it

hard to breathe. "Progressive" means the
disease gets worse over time.
‡ "COPD" includes two main conditions²
emphysema and chronic obstructive
bronchitis
 hat is emphysema?

‡ There is permanent enlargement of the

alveoli due to the destruction of the walls
between alveoli in emphysema. The
destruction of the alveolar walls reduces
the elasticity of the lung overall. Loss of
elasticity leads to the collapse of the
bronchioles obstructing airflow out of the
alveoli. Air becomes "trapped" in the
alveoli and reduces the ability of the lung
to shrink during exhalation
 hat is chronic bronchitis?

‡ Chronic bronchitis involves inflammation and swelling

of the lining of the airways that leads to narrowing
and obstruction of the airways. The inflammation also
stimulates production of mucous (sputum), which can
cause further obstruction of the airways. Obstruction
of the airways, especially with mucus, increases the
likelihood of bacterial lung infections. Chronic
bronchitis usually is defined clinically as a daily cough
with production of sputum for three months, two
years in a row. This definition was developed
primarily for research so that like patients could be
compared.
 Overview of COPD
‡ The air that you breathe goes down your windpipe into tubes in
your lungs called bronchial tubes, or airways.
‡ The airways are shaped like an upside-down tree with many
branches. At the end of the branches are tiny air sacs called
alveoli (al-VEE-uhl-eye).
‡ The airways and air sacs are elastic. When you breathe in,
each air sac fills up with air like a small balloon. When you
breathe out, the air sac deflates and the air goes out.
‡ In COPD, less air flows in and out of the airways because of
one or more of the following:
‡ The airways and air sacs lose their elastic quality.
‡ The walls between many of the air sacs are destroyed.
‡ The walls of the airways become thick and inflamed (swollen).
‡ The airways make more mucus than usual, which tends to clog
the airways
 Expected Duration
‡ Symptoms of chronic bronchitis tend to
begin in smokers after age 50. These
symptoms persist and gradually worsen for
the rest of the smoker's life unless he or
she quits smoking.
‡ Most cases of emphysema are diagnosed
in smokers in their 50s or 60s. People with
the inherited form of emphysema can show
symptoms as early as age 30. Regardless
of the cause, emphysema has no cure and
lasts a lifetime.
Most Common Infectious Causes of COPD
Exacerbations
‡ hild to moderate exacerbations
‡ Streptococcus pneumoniae
‡ Haemophilus influenzae
‡ Moraxella catarrhalis
‡ Chlamydia pneumoniae
‡ Mycoplasma pneumoniae
‡ Viruses
‡ Severe exacerbations
‡ Pseudomonas species
‡ Other gram-negative enteric bacilli
 Signs and Symptoms

‡ COPD can cause coughing that produces large

amounts of mucus (a slimy substance),
‡ wheezing
‡ shortness of breath
‡ chest tightness
‡ Weight loss
‡ and other symptoms.
 Cause of COPD

‡ Cigarette smoking and second-hand

smoke
‡ Air pollution
‡ occupational pollutants such as cadmium
and silica
 vow is COPD diagnosed?

‡ chest X-ray, computerized tomography (CAT or

CT scan) of the chest
‡ tests of lung function (pulmonary function tests)
and the measurement of carbon dioxide and
oxygen levels in the blood.
‡ checking for rapid breathing;
‡ a bluish tint to your skin,
‡ lips or fingernails;
‡ a distended, barrel-shaped chest;
‡ use of neck muscles to breathe; abnormal
breath sounds;
‡ and signs of heart failure, especially
swelling in the ankle and legs.
‡ COPD is often suspected in chronic
smokers who develop shortness of breath
with or without exertion
‡ have chronic persistent cough with sputum
production, and frequent infections of the
lungs such as bronchitis or pneumonia.
‡
 Prevention
‡ Because the majority of cases of COPD are
related to smoking, you can drastically reduce
your risk of this illness by avoiding cigarettes.
If you smoke, get the help you need to stop. If
you don't smoke, don't start. You also may
reduce your risk of COPD by limiting your
exposure to secondhand smoke and by
avoiding outdoor activities when air pollution
levels are high.
‡ If you have been diagnosed with chronic
bronchitis, avoid contact with anyone with
symptoms of an upper respiratory tract
infection, because even a mild cold can
trigger a flare-up of bronchitis symptoms.
Wash your hands frequently and avoid
touching your face with your hands during
the cold and flu season. Also, anyone with
COPD should be vaccinated against
influenza and pneumococcal pneumonia.
 hat treatment is available for COPD?

‡ The goals of COPD treatment are:

‡ to prevent further deterioration in lung function;
‡ to alleviate symptoms;
‡ to improve performance of daily activities and quality of
life.
‡ The treatment strategies include:
‡ quitting cigarette smoking;
‡ taking medications to dilate airways (bronchodilators)
‡ and decrease airway inflammation;
‡ vaccination against flu influenza and pneumonia;
‡ regular oxygen supplementation; and
‡ pulmonary rehabilitation.
 ±
SI± P
IO
ITIES

]. Maintain airway patency.

2. Assist with measures to facilitate gas
exchange.
3. Enhance nutritional intake.
4. Prevent complications, slow progression
of condition.
5. Provide information about disease
process/prognosis and treatment regimen.
‡ Control stress.
‡ Take your medicines such as inhalers,
steroids and antibiotics as ordered.
‡ Do home oxygen therapy if ordered.
‡ Attend a pulmonary rehab program to
learn about COPD and exercise to
‡ Improve your health.
 Pathophysiology of COPD

The pathophysiology of COPD is very complex and is

not clearly identified as yet. A resistance to the airflow
can be attributed to many factors such as mucociliary
disorders, inflammatory responses and structural
changes. In short, the blockage and/or narrowing of the
airways may be caused due to loss of elasticity of the
airways, damage or inflammation in the walls of the
airways, secretion of excess mucous in the airways and
decrease in the surface area for the exchange of air.
According to medical studies, it is revealed that chronic
inflammatory responses of the airways is the major
contributing factor to the development of COPD. It is
stated that inflammatory responses resulted from COPD
and those from asthma are different.
‡ COPD associated inflammation induces the
production of neutrophils, macrophages and
lymphocytes. These cells along with reactive
oxygen and proteases enzymes are responsible
for causing damage to the airways (alveoli).
When smoking, the number of neutrophils is
increased than the normal level. Gradually, the
airways are thickened, excess smooth muscles
and connective tissues are produced by the body,
leading to fibrosis in the airways. All these
inflammatory responses are caused due to
prolonged cigarette smoking and at times,
frequent exposure to lung irritants.