COPD (Chronic Obstructive Pulmonary Disease)

General Information
Chronic pulmonary (lung) disease, often called chronic obstructive pulmonary disease or COPD, usually involves a combination of chronic bronchitis and emphysema. Inflammation in the large air passages in the lungs causes chronic bronchitis, which in turn causes persistent irritation. The result is chronic cough with sputum production that generally occurs for 3 or more months of the year.

Emphysema is a condition of enlarged or overdistended air sacs in the lung. The air sacs are enlarged at the expense of lung tissue. There is less lung to breathe with, and this distortion makes breathing with the remaining lung less efficient. When emphysema occurs with chronic bronchitis, the disease may become severe enough for patients to suffer respiratory insuffi- ciency (lung failure).

The changes in the airways in the lungs that occur with chronic bronchitis are a result of exposure to airborne irritants plus recurrent and chronic infections in the bronchi. The most common of these irritants is cigarette smoke, but there are many occupational exposures, as well as exposures to airborne pollutants in the environment.

The chronic irritation that results can increase the secretion of mucus in the lungs. There is difficulty in clearing the excess secretions, and this may add to the development of emphysema.

Important Points in Treatment
Management includes the use of adequate fluids and humidity to help you cough up excess secretions. Your physician may prescribe medications to help thin these secretions. Take care to avoid lung irritants. You must also take extraordinary care to avoid and, if necessary, to obtain treatment for upper respiratory tract infections and influenza. Patients with chronic bronchitis are much more susceptible to secondary infection, complicating colds or flu and perhaps causing pneumonia. Vaccination and careful, prudent personal hygiene are in order, but these preventives are not perfect. Report even minor respiratory tract infections to your physician promptly for treatment and sometimes to receive prophylaxis to prevent the development of pneumonia.

Notify Our Office If ...

• You have any sign of respiratory tract infection. Seek medical help from your physician at the first sign of respiratory tract infection.
• You are interested in stopping smoking. Many approaches are now available for smoking cessation. Not every program is suitable for every patient. We can help you decide which program might best fit your needs.

General Information
Chronic pulmonary (lung) disease, often called chronic obstructive pulmonary disease or COPD, usually involves a combination of chronic bronchitis and emphysema. Inflammation in the large air passages in the lungs causes chronic bronchitis, which in turn causes persistent irritation. The result is chronic cough with sputum production that generally occurs for 3 or more months of the year.

Emphysema is a condition of enlarged or overdistended air sacs in the lung. The air sacs are enlarged at the expense of lung tissue. There is less lung to breathe with, and this distortion makes breathing with the remaining lung less efficient. When emphysema occurs with chronic bronchitis, the disease may become severe enough for patients to suffer respiratory insufficiency (lung failure).

Emphysema is a result of breathing in irritants. In addition, many patients inherit a predisposition to the development of emphysema. Avoiding the inhalation of irritants can prevent or delay the development of emphysema. In patients already affected, avoidance of irritants can slow or arrest the progress of the disease.

Important Points in Treatment
The first and most prevalent irritant to avoid is cigarette smoke. In some areas, exposure to high levels of air pollution is an additional problem. Relocation is a solution, but this may not be possible for all. Maintaining a dust-free room and using filters with forcedair heating or air-conditioning systems can provide a bridge to survive difficult days. Prevention of influenza and pneumonia with vaccine, as well as careful treatment of upper respiratory tract infections and flu with adequate fluids, can prevent crippling and life-threatening lung infections.

As emphysema progresses, respiratory therapy may be needed to promote drainage from the lungs and to keep the airways clean. Respiratory therapy can also supplement the oxygen supply. Respiratory failure and the effort of breathing may cause weakness and impose restrictions on activity. A creative approach is necessary to perform the daily tasks of living. Regulate your activities to avoid exposure to respiratory insults. Adjust your environment and your diet to simplify the tasks of daily living. Preserve your independence.

Notify Our Office If ...

• You have any sign of respiratory tract infection. Seek medical help from your physician at the first sign of respiratory tract infection.
• You are interested in stopping smoking. There are many approaches now available for smoking cessation. Not every program is suitable for every patient. We can help you to decide which program might best fit your needs.

Metered Dose Inhaler

General Information
Metered dose inhalers are commonly used to provide a dose of medication directly into the breathing passages leading to the lungs. They are often used in patients with asthma, bronchitis, and chronic obstructive pulmonary disease. They must be used properly to get their full effect. They must also be used properly to prevent overdosing on the drug administered. The medications administered by metered dose inhalers are often powerful drugs that must be taken only in the proper dose.

Important Points in Therapy
The inhaler must contain a drug to be effective. Most are metal canisters and one cannot see if they are empty. If you suspect that the inhaler is empty, try floating the canister in a bowl of water. If it sinks it contains some drug. If it floats it may be empty. Shake the inhaler well before use. Assemble it according to the manufacturer’s instructions.

Position the inhaler according to the instructions provided with it. Various kinds of inhalers may require different positions in or in front of the mouth to be effective.

Tilt back your head and breathe out as much as possible. Then take a slow, deep breath in and press the inhaler to release the drug at the same time.

Hold the breath in to a count of 10 if possible.

Breathe out slowly.

If the prescription calls for more than one dose, allow a minute or two between doses.

Rinse and dry the inhaler and store at room temperature.


Notify Our Office If ...

• You are having difficulty with the use of your inhaler.