COPD - lung disease: treatment and symptoms, list of drugs

What is COPD?

COPD is an umbrella term for many respiratory diseases such as asthma, emphysema and chronic bronchitis. May also include other respiratory diseases.

The most common causative factor is smoking.

Inflammatory processes in the lungs, provoked by exposure to exhaust, various impurities of atmospheric air, cigarette smoke (passive smoking is not excluded) are fundamental processes for the development of COPD.

According to statistics from the World Health Organization (WHO), chronic obstructive pulmonary disease in adults ranks fourth in mortality.

People suffering from this disease die from developing complications such as:

• lungs' cancer;
• respiratory failure;
• cardiovascular disorders (which are caused by COPD).

This disease, if properly diagnosed in the early stages of development, can be fully treated; by using a number of actions to prevent this disease, it is possible to prevent its development.

According to ICD 10, they are coded as J 44.0 - if COPD develops together with ARVI affecting the lower respiratory tract. The International Classification of Diseases code 10 helps to systematize and track statistics for each disease.

COPD icd 10 with code J44.9 is reflected with an unknown genesis.

Definition of disease

Chronic obstructive pulmonary disease is a pathological inflammatory process in the lungs, the main consequence of which is the inability to breathe normally. A constant lack of oxygen in the body gradually leads not only to constant shortness of breath and painful coughing attacks. At the same time, physical activity decreases, since in the later stages even an attempt to climb a few steps on the stairs causes severe shortness of breath.

The insidiousness of the disease is that it can occur without a cough, which is why it is often diagnosed late.

The main symptoms of COPD are:

1. Dry cough. In the early stages, it may not appear, which complicates the early diagnosis of the disease. But more often than not, a mild cough without sputum is not taken seriously, which is why a person seeks help from a doctor too late.
2. Sputum. After some time, the cough becomes wet, with clear sputum being coughed up. In the later stages, the sputum becomes thick and abundantly secreted, often interspersed with pus.
3. Shortness of breath . This is a symptom caused by a lack of oxygen in the body and a chronic inflammatory process in the lungs. It manifests itself at the last stage of COPD development, when changes in the lung tissue become irreversible. It can manifest itself with significant physical exertion, or with the weakest ARVI.

In addition, it provokes increased secretion of mucus in the bronchi, pulmonary hypertension, as well as various gas exchange disorders, as well as hemoptysis. Chronic obstructive pulmonary disease has the following main phases:

1. First. The disease itself is mild, often manifested only by rare bouts of coughing. At this stage, pathological changes in the lungs are almost invisible. At this stage, further development of the disease in some cases can be stopped with timely treatment.
2. Second. In the second stage, people most often begin to seek medical help. The cause is sharply manifested symptoms, such as cough with sputum and incipient shortness of breath. Pathological changes in the lungs become irreversible. After this, treatment can be aimed only at inhibiting painful symptoms.
3. Third . At the third, rather severe stage, the volume of air entering the lungs sharply decreases. This is associated with the development of obstructive phenomena, characterized by severe shortness of breath and coughing attacks with purulent sputum;
4. Fourth. The most severe stage, leading to complete loss of ability to work, and often posing a threat to life. It is at this stage that a pathology such as “pulmonary heart” appears and respiratory failure appears.

The development of chronic obstructive pulmonary disease is provoked by such main factors as:

• Long-term smoking;
• Polluted air in the house (for example, due to the use of solid fuel for heating);
• Low socio-economic status of the person or his family;
• Chronic infectious diseases of the lower respiratory tract (chronic obstructive bronchitis or bronchial asthma);
• Adenoviral infection;
• Vitamin C deficiency in the body;
• Conditions of professional activity associated with the presence of dust and chemical vapors in the air (varnishes, paints, gases).

Another common cause of COPD is the so-called “passive smoking”. That is why health problems arise not only for the smoker himself, but also for all members of his family. This is especially dangerous for children, as it increases the risk of developing COPD in the future.

Proper and timely treatment of lower respiratory tract diseases in childhood helps prevent the development of COPD in adulthood.

Risk factors

• For the most part, the most harmful and frequently encountered factor is smoking. Tobacco smoke and cigarette tar negatively affect all respiratory organs. Passive smoking is absolutely no less harmful, but on the contrary even more dangerous. A person who is close to a smoker consumes a much higher level of smoke than himself. The category of people who smoke endanger not only themselves, but also the people around them. Among the group of heavy smokers, approximately 15-20% of clinical manifestations of COPD are diagnosed.
• Genetic predisposition. An example of a disorder leading to this disease is a condition such as: alpha-antitrypsin deficiency (the cause of the development of emphysema in people who have never smoked and increases the risk for the disease in smokers);

At what age does COPD usually develop?

Early diagnosis can delay the development of COPD symptoms

According to the US National Heart, Lung, and Blood Institute, COPD is most often diagnosed in people over 40 years of age. In addition, people who smoke or have previously smoked are at greatest risk.

Other risk factors, such as long-term exposure to harmful chemicals, may also play a role in the development of COPD.

COPD usually develops over time, and the longer a person is exposed to exposure, the more likely it is that they will one day be diagnosed with COPD.

The lungs of young people can recover from potential irritants more quickly than the lungs of older people. In addition, small and isolated lung injuries may not be enough to cause symptoms of COPD to begin to appear, since the condition usually takes years to become noticeable.

Pathogenesis

With prolonged exposure to any risk factor on the human body, inflammation of the walls of the bronchial tubes of a chronic nature develops. Damage to the distal section is most likely (located in maximum proximity to the alveoli and pulmonary parenchyma).

The production and elimination of mucus is impaired. Small bronchi become clogged and against this background various types of infections develop. Muscle cells die and are replaced by connective tissue. As a result, emphysema develops - the lung tissue is filled with air, which causes their elasticity to noticeably decrease.

From bronchi damaged by emphysema, air is released with great difficulty. The volume of air is reduced because gas exchange does not occur at the proper quality. As a result, one of the main symptoms appears – shortness of breath. When exercising or just walking, shortness of breath creates an increasing effect.

As a result of respiratory failure, hypoxia develops. With prolonged exposure to hypoxia on the human body, the lumens of the pulmonary vessels decrease, this leads to pulmonary hypertension (during this disease, heart failure develops, enlargement and expansion of the right chambers of the heart).

Prevention of COPD

Preventive measures for COPD require compliance with the following factors:

• it is necessary to stop using tobacco products (a very effective, proven method for rehabilitation);
• Flu vaccination helps to avoid another exacerbation of obstructive pulmonary disease (it is better to get vaccinated before winter);
• revaccination against pneumonia reduces the risk of exacerbation of the disease (indicated every 5 years);
• It is advisable to change place of work or residence if they have a detrimental effect on health, increasing the development of COPD.

Classification

This disease is classified according to the severity of its course and clinical picture.

• Latent , almost impossible to recognize, has no pronounced symptoms.
• Moderate severity , cough manifests itself in the first half of the day (with sputum or dry). Shortness of breath is more common with minor physical exertion.
• Severe course , occurs in a chronic course and is accompanied by attacks of severe coughing with sputum production, frequent shortness of breath.
• The fourth stage can be fatal and is characterized by a persistent cough, shortness of breath even at rest, and a rapid decrease in body weight.

Recommendations given to patients to slow the progression of the disease

The rate at which COPD progresses largely depends on the effectiveness of treatment, as well as on the patient’s lifestyle. It is recommended to follow all doctor's instructions:

1. Stop smoking.
2. Eat well. Give preference to foods rich in protein and vitamins.
3. Do special breathing exercises.
4. Try to boost your immunity.
5. Maintain as much physical activity as possible.
6. Monitor your body weight. If necessary, fight excess weight.
7. Take medications . Medicines are used to facilitate the discharge of sputum and increase bronchial patency, as well as drugs with antibacterial effects and drugs that reduce pulmonary edema.

Exacerbation

Let's look at what an exacerbation of COPD is.

This is a condition in which the course of the disease is aggravated. The clinical picture worsens, shortness of breath increases, coughing attacks become more frequent and intensify. General depression of the body sets in. The treatment that was used previously does not bring a positive effect. In most cases, the patient requires hospitalization, review and adjustment of previously prescribed treatment.

A condition of exacerbation may develop against the background of a previous illness (ARI, bacterial infections). A common upper respiratory tract infection for a person with COPD is a condition in which the functionality of the lungs is significantly reduced. The normalization period takes longer.

A condition such as exacerbation of COPD is diagnosed based on symptomatic manifestations, patient complaints, hardware and laboratory tests).

Severity of COPD

Previously, chronic obstructive pulmonary disease was considered as a general concept, which included emphysema, bronchitis, byssinosis, some forms of asthma, cystic fibrosis and other lung diseases.

Today, the term COPD includes some types of bronchitis, pulmonary hypertension, emphysema, pneumosclerosis, and cor pulmonale. All these diseases reflect changes typical of various degrees of COPD, which combine chronic bronchitis with pulmonary emphysema.

Without a correct determination of the type of illness and the severity of its course, it is impossible to select adequate therapy. A mandatory criterion for diagnosing COPD is bronchial obstruction, the degree of which is assessed using peak flowmetry and spirometry.

There are four degrees of severity of COPD. The disease can be mild, moderate, severe, or extremely severe.

Light

The first degree of the disease in the vast majority of cases is not clinically manifested and there is no need for ongoing therapy. A rare wet cough is possible; emphysematous COPD is characterized by the appearance of mild shortness of breath.

At the initial stage of the disease, a reduced gas exchange function is detected in the lungs, but air circulation in the bronchi has not yet deteriorated . Such pathologies do not affect the quality of life of a person in a calm state. For this reason, with COPD of the 1st degree of severity, sick people rarely come to see a doctor.

Average

With COPD severity level 2, a person suffers from a constant cough with viscous sputum. In the morning, as soon as the patient wakes up, a lot of sputum is released, and shortness of breath appears during physical activity. Sometimes periods of exacerbation of the disease appear, when the cough sharply intensifies and the production of sputum with pus increases. Endurance during physical effort is significantly reduced.

Emphysematous COPD of the 2nd degree of severity is characterized by shortness of breath, even if the person is relaxed , but only during an exacerbation of the disease. During remission it is not present.

Exacerbations are observed very often in the bronchitis type of COPD: wheezing can be heard in the lungs, muscles (intercostals, neck, wings of the nose) are involved in breathing.

Heavy

In severe COPD, cough with sputum production and wheezing are constantly observed, even if the period of exacerbation of the disease has passed. Shortness of breath begins to bother you even with little physical effort and quickly becomes severe. Exacerbations of the disease occur twice a month, and sometimes more often, sharply worsening a person’s quality of life. Any physical effort is accompanied by severe shortness of breath, weakness, darkening of the eyes and fear of death.

Breathing occurs with the participation of muscle tissue; in the emphysematous type of COPD it is noisy and heavy, even when the patient is at rest. External symptoms of the disease appear: the chest becomes wide, barrel-shaped, blood vessels protrude on the neck , the face becomes puffy, and the patient loses weight. The bronchitis type of COPD is characterized by bluish skin and swelling. Due to a sharp decrease in endurance during physical effort, a sick person becomes disabled.

Extremely heavy

The fourth degree of the disease is characterized by respiratory failure. The patient constantly coughs and wheezes, shortness of breath torments even in a relaxed state, and respiratory function is difficult. Physical effort becomes minimal, since any movement causes severe shortness of breath. The patient tends to lean on something with his hands , since this position makes exhalation easier due to the involvement of auxiliary muscles in the breathing process.

Exacerbations become life-threatening. Cor pulmonale is formed, a severe complication of COPD that leads to heart failure. The patient becomes disabled , he needs ongoing therapy in a hospital or the purchase of a portable oxygen tank, since the person cannot breathe fully without it. The average life expectancy of such patients is approximately 2 years.

How does COPD affect the body?

Any chronic disease has a negative impact on the body in general. Thus, COPD leads to disorders that would seem to have nothing to do with the physiological structure of the lungs.

• Dysfunction of the intercostal muscles (involved in the act of breathing), muscle atrophy may occur;
• Osteoporosis;
• Decreased glomerular filtration rate of the kidneys;
• The risk of thrombosis increases;
• Cardiac ischemia;
• Decreased memory;
• Tendency to depression;
• Decreased protective functions of the body.

COPD in young people

The progressive nature of COPD determines the fact that this disease develops much less frequently in young people. However, sometimes this also happens.

Harmful factors may not affect a person's respiratory system for long enough to cause COPD to develop, but people who are at risk, such as heavy smokers or working in polluted environments, should be aware of the risks they pose and take steps to to limit harmful effects as much as possible.

Diagnostics

• Blood analysis. This test is mandatory for diagnosing COPD. In the acute stage, an increased ESR and neutrophilic leukocytosis can be observed. In patients with developing hypoxia, there is an increase in the number of red blood cells, a low ESR and increased hemoglobin.
• Sputum analysis, what is it - this is the most important procedure for patients who produce sputum. The results of such an analysis can provide answers to many questions. The nature of inflammation, the degree of its severity. You can also trace the presence of atypical cells; in diseases of this kind, you need to make sure that there is no cancer.

The sputum in patients with COPD is mucous, and in the acute stage it can be purulent. The viscosity of sputum increases, as does its quantity, the color acquires a greenish tint with streaks of yellow.

Sputum analysis is still necessary for such patients, because thanks to it it becomes possible to determine the causative agents of infection and their resistance to one or another drug of the antibacterial group.

• An X-ray diagnostic method is required for correct diagnosis and exclusion of other lung diseases (many diseases of the respiratory system may have a similar clinical picture). An x-ray is taken in two positions, frontal and lateral.

During periods of exacerbation, it helps to exclude pneumonia or pulmonary tuberculosis.

• An ECG is used to exclude or confirm such a diagnosis as cor pulmonale (hypertrophy of the muscles of the right heart).

The step test, at the initial stage of the disease, usually such a symptom as shortness of breath is not clearly expressed and for diagnosis it is necessary to check whether it is present with slight physical activity.

Pulmonary rehabilitation for COPD

Our Pulmonology Department has developed a “Pulmonary Rehabilitation Program for Patients with Chronic Obstructive Pulmonary Disease.”
A course of complex therapy can replace bronchoscopic sanitation in patients with bronchiectasis.

• sputum becomes easily coughed up, coughing occurs naturally, medications are poured into the smallest bronchi, including antimicrobial agents.
• the introduction of drugs into the bronchus and removal of sputum is not invasive and traumatic.
• Due to the positive effect of drainage techniques and special exercises included in the course, lymphatic drainage of the bronchi and their blood supply improve. As a result, the protective properties of the mucous membrane of damaged bronchi and surrounding lung tissue are enhanced.
• There are no risks inherent in bronchoscopy: the risk of bleeding, damage and allergic reaction to anesthesia.

Symptoms to watch out for

Let's look at a number of symptoms that you should pay attention to and, if necessary, consult a doctor for a correct diagnosis.

• Often recurrent acute bronchitis;
• Attacks of painful coughing, their number gradually increasing;
• Cough with constant mucus production;
• Increased body temperature;
• Attacks of shortness of breath, which intensifies as the disease progresses.

How does COPD progress with age?

Frequent cough may be a symptom of COPD

COPD progresses differently in each case, but people may experience some common symptoms both before diagnosis and as the disease progresses.

The rate at which symptoms develop varies from person to person and depends on several factors, including age, the quality of treatment the person receives, and the severity of the disease.

Early symptoms of COPD include the following:

• dyspnea;
• labored breathing;
• chest pain or tightness;
• difficulties in physical activity or performing simple movements due to respiratory failure;
• a regularly observed cough that often produces large amounts of mucus or phlegm;
• wheezing;
• frequent respiratory infections;
• general lack of energy.

Treatment

There are several basic principles for treating this disease.

• Complete cessation of the harmful habit of smoking;
• Medicinal method of treatment, using medications of various groups;
• Vaccination against infections caused by pneumococcus and influenza virus;
• Moderate physical activity has a significant effect;
• Oxygen inhalation is used for severe respiratory failure as a way to prolong life.

Groups of drugs used in treatment

• Bronchodilators (atrovent, salbutamol, aminophylline);
• Hormonal drugs from the group of corticosteroids (Symbicort, Seretide);
• Drugs that promote sputum discharge (ambrobene, codelac);
• Immunomodulatory agents (immunal, derinat);
• Preparations of the group of phosphodiesterase 4 inhibitors (Daxas, Daliresp).

Recommendations and prevention

Chronic obstructive pulmonary disease is most often incurable, but with the right algorithm of actions you can live an almost full life. This allows you to reduce the frequency of exacerbations and extend periods of stable rehabilitation. To do this, the patient is recommended to follow these recommendations:

1. Regularly visit your doctor and strictly follow his instructions;
2. Follow a daily routine, sleep at least 8 hours;
3. Avoid unnecessary physical and emotional stress.

As with most pulmonary diseases, a complete and balanced diet rich in vitamins and microelements is of great importance.

One of the important components of a lifestyle with COPD is a high-calorie diet and strictly dosed physical activity.

It is easier to prevent such a serious disease as COPD than to treat it for a very long and difficult time. Prevention of COPD includes:

1. Complete smoking cessation;
2. Vaccination against influenza and pneumococcal infection;
3. Timely treatment of infectious diseases of the respiratory tract;
4. Active lifestyle, including regular physical activity.

You should also avoid working in hazardous industries and, if necessary, use personal protective equipment.

Treatment of tuberculosis with folk remedies at home

This article will tell you what antibiotics to take for pneumonia.

Diagnosis of pneumonia //drlor.online/zabolevaniya/legkix/pnevmoniya/kak-opredelit-v-domashnix-usloviyax.html

Treatment of COPD with folk remedies

Some symptoms of this disease can be treated using traditional medicine recipes.

It is important to remember the need to consult with a specialist! Treatment with alternative medicine is an addition to the treatment that should be prescribed by a doctor.

Steam inhalations

This procedure can be done easily at home. You will need a container for the solution, a towel and a little time.

• For one liter of hot water (90-100 degrees), 5-6 drops of pine essential oil, eucalyptus oil and chamomile.
• Inhalations with the addition of sea salt (liter of boiling water, 2-3 tablespoons of sea salt).
• Inhalation of a collection of herbs mint, calendula and oregano (2 tablespoons of collection per liter of boiling water).

Also, in the treatment of chronic pulmonary obstruction, inhalation with a nebulizer can be done.

Treatment at home

Extremely heavy

How to treat COPD? Doctors say that this type of chronic pulmonary pathology cannot be completely cured. The development of the disease is stopped by timely prescribed therapy. In most cases, it helps improve the condition. Few achieve complete restoration of normal functioning of the respiratory system (lung transplantation is indicated for severe COPD). After confirmation of the medical report, lung disease is eliminated with medications in combination with folk remedies.

Drugs

The main “doctors” in the case of respiratory pathology are considered to be bronchodilator drugs for COPD. For a complex process, other medications are also prescribed. An approximate course of treatment looks like this:

1. Beta2 agonists. Long-acting drugs – “Formoterol”, “Salmeterol”; short - salbutamol, terbutaline.
2. Methylxanthines: Aminophylline, Theophylline.
3. Bronchodilators: tiotropium bromide, oxitropium bromide.
4. Glucocorticosteroids. Systemic: Methylprednisolone. Inhalation: Fluticasone, Budesonide.
5. Patients with severe and extremely severe COPD are prescribed inhaled medications with bronchodilators and glucocorticosteroids.

Treatment of COPD with folk remedies is recommended in combination with medications. Otherwise, there will be no positive results from traditional medicine recipes. Several effective grandmother’s recipes for combating COPD:

1. Take 200 g of linden blossom, the same amount of chamomile and 100 g of flax seeds. We dry the herbs, chop them, and infuse them. For one glass of boiling water put 1 tbsp. l. collection Take 1 time per day for 2-3 months.
2. Grind 100 g of sage and 200 g of nettle into powder. Pour boiled water over the mixture of herbs and leave for an hour. We drink half a glass twice a day for 2 months.
3. Collection for removing sputum from the body during obstructive inflammation. We will need 300 g of flaxseeds, 100 g of anise berries, chamomile, marshmallow, licorice root. Pour boiling water over the mixture and leave for 30 minutes. Strain and drink half a glass every day.

What do scientists say?

COPD, the causes of the disease, treatment methods - all this has long attracted the attention of doctors. In order to have sufficient materials for research, data was collected, during which cases of the disease were studied in residents of rural areas and urban residents. The information was collected by Russian doctors.

It was possible to reveal that if we are talking about those who live in a village, then here with COPD the severe course often becomes ineffective, and in general the pathology torments the person much more severely. Endobronchitis with purulent discharge or tissue atrophy was often observed in villagers. Complications with other somatic diseases occur.

It has been suggested that the main reason is the low quality of medical care in rural areas. In addition, in villages it is impossible to do spirometry, which is necessary for smoking men aged 40 years or more.

How many people know COPD – what is it? How is it treated? What happens when this happens? Largely due to ignorance, lack of awareness, and fear of death, patients become depressed. This is equally characteristic of both urban and rural residents. Depression is additionally associated with hypoxia, which affects the patient’s nervous system.

What if with medications?

Of course, you can’t do without drug therapy for COPD either. First of all, pay attention to vaccines against influenza and pneumococcus. It is best to get vaccinated in October-mid-November, since then the effectiveness decreases, the likelihood increases that there have already been contacts with bacteria and viruses, and the injection will not provide an immune response.

They also practice therapy, the main goal of which is to expand the bronchi and keep them in normal condition. To do this, they fight spasms and use measures that reduce the production of sputum. The following medications are useful here:

• theophyllines;
• beta-2 agonists;
• M-anticholinergics.

The listed drugs are divided into two subgroups:

• long-acting;
• short action.

The first group maintains the bronchi in normal condition for up to 24 hours, the second group lasts 4-6 hours.

Short-acting medications are relevant at the first stage, as well as in the future, if there is a short-term need for this, that is, symptoms suddenly appear that need to be urgently eliminated. But if such medications do not provide sufficient results, they resort to long-acting medications.

Also, anti-inflammatory drugs should not be neglected, as they prevent negative processes in the bronchial tree. But you also can’t use them outside of doctors’ recommendations. It is very important that the doctor supervise drug therapy.

Surgery

There are surgical treatments for COPD. A bullectomy is performed to relieve symptoms in patients with large bullae. But its effectiveness has been established only in those who quit smoking in the near future. Thoroscopic laser bullectomy and reduction pneumoplasty (removal of an overinflated part of the lung) have been developed.

But these operations are currently only used in clinical trials. There is an opinion that if there is no effect from all the measures taken, you should contact a specialized center to resolve the issue of lung transplantation

Complications

Like any other inflammatory process, obstructive pulmonary disease sometimes leads to a number of complications, such as:

• pneumonia (pneumonia);
• respiratory failure;
• pulmonary hypertension (increased pressure in the pulmonary artery);
• irreversible heart failure;
• thromboembolism (blockage of blood vessels with blood clots);
• bronchiectasis (development of functional inferiority of the bronchi);
• cor pulmonale syndrome (increased pressure in the pulmonary artery, leading to thickening of the right heart);
• atrial fibrillation (heart rhythm disorder).

BODE index

Another measure that uses more than just FEV1 to assess a person's COPD status and outlook is the BODE index. BODE means:

• body mass
• Airflow obstruction
• Dyspnea
• Exercise stress

BODE takes into account the big picture of how COPD affects your life. Although the BODE index is used by doctors, its value in predicting disease progression and life expectancy may decrease as researchers learn more about the disease.

Body mass

Body mass index (BMI), or height-adjusted weight, can determine whether a person is overweight or obese. BMI can also determine whether you are too thin. Worse people have worse prospects.

Airflow obstruction

This applies to FEV1, as in the GOLD system.

Dyspnea

Some studies show that those who have more breathing problems have a higher chance of survival than those who have better breathing abilities.

Exercise

This means how well you can tolerate exercise. This is often measured by a test called the 6-minute walk.

Symptoms and diagnosis

How is the disease diagnosed? Symptoms depend on the stage of the disease:

1. Easy. There are almost no symptoms, only occasionally an unreasonable wet cough bothers you. In most patients, the initial stage goes unnoticed due to mild symptoms. Determining the pathology in the bronchi at this stage makes it possible to significantly slow down the progression of the disease only through lifestyle changes and preventive treatment.

2. Average. Shortness of breath appears after moderate physical activity. The cough can be dry and wet, but sputum is always released after a change in body position, for example, a person feels mucus in the mouth after getting out of bed. Parents should be more careful: if a child constantly coughs and avoids active games that he enjoyed playing before, then it is worth consulting with a pulmonologist.

3. Heavy. Here, shortness of breath appears even with minor physical effort, and sputum is constantly expelled. Such patients try to move less and often cannot sleep lying down, preferring to place several pillows under their back while sleeping. Externally, such patients have cyanosis and pale skin, and periodic wheezing can be heard when breathing.

4. Very heavy. The feeling of lack of air appears even at rest. Patients take a forced body position and try to move less; skin cyanosis and wheezing become constant. Children refuse to eat and lose a lot of weight. The severe stage is very life-threatening; it causes chronic oxygen starvation of the body.

But the diagnosis of COPD is made not only on the basis of emerging symptoms; its manifestations, especially at an early stage, can be confused with other ailments. Before making a final diagnosis, differential diagnosis is carried out with asthma, bronchiectasis, and tuberculosis.

To do this, the patient is prescribed a number of studies:

1. Spiromitria. What it is? During this procedure, the patient is asked to exhale air into a special device. The exhalation rate will show how impaired the respiratory functions are.

2. X-rays of light.
3. Bronchoscopic examinations.
4. CT scan.
5. Sputum analysis. Sputum is examined for tuberculosis and the presence of other pathogenic microorganisms.
6. General blood analysis. Changes in the leukocyte blood count will indicate an existing chronic inflammatory process.

Read also: Cotton wool is made from cotton

Only on the basis of all examination data is a diagnosis of COPD made.

List of important drugs

List of groups of drugs that are used in clinical practice for COPD:

• Bronchodilators (bronchodilators): beta-2 mimetics, anticholinergics and possibly methylxanthines.
• Anti-inflammatory drugs: cortisone drugs (corticosteroids) and PDE-4 inhibitors.

Cortisone medications are one of the medications for COPD.
Other medications are designed to improve the secretion of mucus in the bronchi and relieve coughing. For acute respiratory illnesses, antibiotics may be helpful. Vaccinations against influenza or pneumococcus may protect against additional infections that make breathing more difficult.

Airway dilators

The drug group of bronchodilators includes beta-2 mimetics, anticholinergics and methylxanthines. Medicines are used in the form of inhalations, which have a small number of side effects.

The drugs reduce muscle tension in the bronchi and expand the airways, which narrow in COPD. They also prevent recurrent bronchitis.

Beta-2 mimetics

There are short- and long-acting beta-2 mimetics. Short-acting drugs include fenoterol, salbutamol or terbutaline, long-acting formoterol and salmeterol.

Short-acting drugs are used as needed, for example, in acute respiratory failure. They act quickly, but only for 4 to 6 hours. Long-acting beta-2 receptor mimetics are taken regularly. The effect lasts about twelve hours.

If COPD has not progressed, it is usually sufficient to use a short-acting beta-2 mimetic if needed. Sudden shortness of breath can usually be relieved by inhaling medications. If symptoms worsen, it makes sense to use a long-acting beta-2 mimetic regularly.

Beta-2 mimetics relieve breathing difficulties and prevent acute respiratory distress attacks (exacerbations). Studies have shown that people who used beta-2 mimetics had better lung function and a better quality of life. Beta-2 agonists are generally well tolerated at normal doses. However, as a side effect, if they are overdosed, the heart rate may become faster or tremors may occur.

There are many different types of inhalers that work the same way, delivering medication directly to the lungs. Inhalers use the drug either in aerosol or powder form. Inhalation devices come in different sizes and are usually made of plastic. The operation of the nebulizer is based on pumping a stream of air or oxygen through the drug solution. The resulting mixture is inhaled using a mask.

Anticholinergics

Anticholinergic drugs work in the same way as beta-2 mimetics against the symptoms of COPD. Also from these drugs there are short-acting and long-acting drugs. The effects of long-acting anticholinergics, tiotropium bromide, last about 24 hours, so they last longer than most beta-2 mimetics.

Medicines need to be inhaled only once a day. Short-acting anticholinergic drugs last only 20-30 minutes and then up to 8 hours. Anticholinergic drugs may also reduce the risk of acute respiratory attacks. As a result, fewer hospital beds are required and the quality of life improves.

Anticholinergic drugs may cause dry mouth as a side effect. Otherwise, these drugs are considered to be well tolerated.

Methylxanthines

Methylxanthines also dilate the respiratory tract. The drug theophylline is usually prescribed from this group of drugs. The drug is usually taken in tablet form. Theophylline relieves symptoms worse than beta-2 mimetics and anticholinergics, and also has more side effects. Therefore, it is generally recommended for patients with COPD only if treatment with beta-2 mimetics and anticholinergic drugs does not respond adequately.

Theophylline is one of the drugs for COPD

Possible side effects of theophylline include headache, insomnia, heart rhythm problems, heartburn, or nausea. At high dosages, seizures may occur. Especially older people with COPD often do not tolerate these drugs well.

Corticosteroids

Cortisone medications are used as needed in addition to bronchodilators. Cortisone helps reduce the risk of acute respiratory distress. For this reason, the inhaled drug is usually used only by people with severe COPD and frequent respiratory problems.

In previous studies, cortisone spray for COPD was only effective when used at a dose greater than 1,000 mcg per day. However, such a high dose increases the risk of developing pneumonia.

A side effect of cortisone spray is a yeast infection in the mouth, which affects about 5 in every 100 people over the course of a year. Almost the same often leads to hoarseness. Therefore, it is recommended to rinse your mouth or brush your teeth after using cortisone.

Cortisone can also help you recover faster during acute respiratory distress, but the medication is then given in pill or syringe form. Possible side effects of cortisone tablets when used over a long period of time include weight gain, increased blood sugar and sleep disturbances.

If the pills are taken continuously, the skin, muscles and bones may also become weakened. Therefore, long-term treatment with cortisone tablets is not recommended.

PDE-4 inhibitors

PDE-4 inhibitors are taken in tablet form as an adjunct to bronchodilators. Medicines suppress inflammation in the bronchi, therefore improving breathing and preventing acute respiratory distress.

Studies have shown that PDE4 inhibitors improve breathing and quality of life:

• In about 5 out of 100 people, the drugs prevent asthma attacks.
• For about 5 in 100 people, medications cause side effects such as nausea and diarrhea, poor appetite, weight loss, sleep disturbances or headaches.

Mucolytics

Mucolytic agents improve mucus secretion in the respiratory tract and relieve coughing. Research shows conflicting results. Mucolytics can reduce the risk of acute respiratory distress when coughing with heavy sputum. However, the drugs do not improve breathing and play a minor role in the treatment of COPD.

Vaccination

Patients with COPD are especially susceptible to complications from influenza. It is recommended to get vaccinated against influenza every year in the fall. Research shows that the vaccine reduces the risk of exacerbations and respiratory infections such as bronchitis or pneumonia.

The influenza vaccine is given to all patients with severe COPD. Side effects usually include redness and swelling at the injection site. Temporary fatigue, headache and mild fever are also possible.

Vaccination is recommended for those at risk of COPD

The pneumococcal vaccine is also in question. Pneumococcal bacteria cause inflammation, particularly in the lungs, middle ear or paranasal sinuses. People with COPD are more likely to suffer from pneumonia and acute respiratory infections if they become infected with pneumococci. Protection lasts for about five years.

Antibiotics

In patients with COPD, respiratory infections can lead to acute respiratory failure. If the infection is caused by bacteria and the symptoms are very severe, antibiotics will improve the symptoms. If the sputum appears yellowish-greenish or purulent, it indicates a bacterial infection.

If the respiratory infection was caused by viruses, antibiotics will not help. Antiviral drugs can cause severe side effects and are therefore not recommended for patients.

Combination of drugs

Depending on the stage of chronic obstructive pulmonary disease, it may be helpful to combine two airway dilation medications. Often these combinations are more effective and have fewer side effects than a higher dose of one drug. The doctor decides which combination is best.

Some severe COPD patients who suffer from a lot of cough and sputum respond well to antibiotics with PDE5 inhibitors. However, current guidelines recommend the drug only in cases of exacerbation.

The same applies to the use of so-called macrolide antibiotics. Long-term treatment with macrolides should only be considered in justifiable exceptional cases - recurrent exacerbations (at least twice a year) and detection of P. aeruginosa.

Combination treatments that combine the use of corticosteroids with long-acting beta-agonists are also available for the treatment of COPD. This type of treatment has been shown to reduce the frequency of exacerbations and improve overall health. Studies have also shown that combining a corticosteroid with a long-acting beta-agonist is more effective than using the individual components.

Risk group

The diagnosis of COPD in adult men in Russia is observed in every third person who has crossed the threshold of 70 years. Statistics allow us to confidently say that this is directly related to tobacco smoking. There is also a clear connection with lifestyle, namely the place of work: the likelihood of developing pathology is higher when a person works in hazardous conditions and with a lot of dust. Living in industrial cities has an effect: here the percentage of cases is higher than in places with a clean environment.

COPD develops more often in older people, but if you have a genetic predisposition, you can get sick at a young age. This is due to the specifics of the body’s generation of connective pulmonary tissue. There are also medical studies that suggest a connection between the disease and the child’s prematurity, since in this case there is not enough surfactant in the body, which is why organ tissues cannot expand correctly at birth.

What is chronic obstructive pulmonary disease (COPD)

The air you inhale flows down through the breathing tube into branches of the windpipe called the bronchi.

In the lungs, your bronchi branch into thousands of small, thin tubes called bronchioles. These tubes end in clusters of tiny round air sacs called alveoli.

Small blood vessels called capillaries pass through the walls of the alveoli. When air reaches the alveoli, oxygen enters through their walls into the blood in the capillaries. At the same time, carbon dioxide (carbon dioxide) moves from the capillaries to the alveoli. This process is called gas exchange.

The airways and alveoli are elastic, and when you inhale, each alveoli fills with air, like a small balloon, and when you exhale, the alveoli become smaller.

With chronic obstructive pulmonary disease, less air enters the lungs and, accordingly, less air leaves them. This happens for one or more of these reasons:

• The airways and alveoli lose their elasticity.
• The walls between many alveoli are destroyed.
• The walls of the airways are swollen and inflamed.
• The airways produce more mucus than usual, which can clog them.

The term COPD includes two main diseases - emphysema and chronic bronchitis. With emphysema, the walls between many of the alveoli are damaged or even destroyed. As a result, the alveoli lose their shape, resulting in the formation of fewer shapeless large alveoli instead of many small ones. If this happens, gas exchange in the lungs worsens.

In chronic bronchitis, the mucous membrane of the respiratory tract is constantly irritated and inflamed. This leads to swelling of the mucous membrane and narrowing of the airways. During chronic bronchitis, thick mucus is present in the respiratory system, which also makes breathing difficult.

Most people with COPD also have emphysema and chronic bronchitis. Thus, the general term "COPD" is more accurate.

Treatment of exacerbation of COPD

The goal of treating exacerbations is to relieve the current exacerbation as much as possible and prevent their occurrence in the future. Depending on the severity, treatment of exacerbations can be carried out on an outpatient basis or in a hospital.

Basic principles of treatment of exacerbations:

• During exacerbation of the disease, the use of short-acting bronchodilators is preferable to long-acting ones. Doses and frequency of administration are usually increased compared to usual. It is advisable to use spacers or nebulizers, especially in severely ill patients.
• It is necessary to correctly assess the severity of the patient’s condition, exclude complications that may masquerade as exacerbations of COPD, and promptly refer for hospitalization in life-threatening situations.
• If the effect of bronchodilators is insufficient, intravenous aminophylline is added.
• If monotherapy was previously used, a combination of beta-stimulants with anticholinergics (also short-acting) is used.
• Dosed oxygen therapy in the treatment of patients in a hospital through nasal catheters or a Venturi mask. The oxygen content in the inhaled mixture is 24-28%.
• Connecting intravenous or oral administration of glucocorticosteroids. An alternative to the systemic use of GCS is inhalation of Pulmicort through a nebulizer, 2 mg twice a day after inhalation of Berodual.
• If there are symptoms of bacterial inflammation (the first sign of which is the appearance of purulent sputum), broad-spectrum antibiotics are prescribed.
• Other measures include maintaining fluid balance, anticoagulants, treatment of concomitant diseases.

What else should you know?

As the severity of COPD increases, attacks of breathlessness become more frequent and severe, while symptoms increase quickly and last longer. It is important to know what to do when asthma attacks occur. Your doctor will help you choose medications that will help with such attacks. But in cases of a very severe attack, it may be necessary to call an ambulance. The optimal option is hospitalization in a specialized pulmonology department, however, if it is absent or full, the patient can be hospitalized in a therapeutic hospital in order to stop exacerbations and prevent complications of the disease.

These patients often develop depression and anxiety over time due to their awareness of the disease becoming worse. Shortness of breath and difficulty breathing also contribute to feelings of anxiety. In such cases, you should definitely talk to your doctor about what types of treatment can be chosen to relieve breathing problems during attacks of shortness of breath.

Symptoms of COPD

The course of COPD is usually progressive, but most patients experience the development of extensive clinical symptoms over several years and even decades.

The first specific symptom of the development of COPD in a patient is the appearance of a cough. At the onset of the disease, the cough bothers the patient only in the morning and is short-lived, however, over time, the patient’s condition worsens and the appearance of a painful hacking cough with the release of copious amounts of mucous sputum. The release of viscous yellow sputum indicates the purulent nature of the secretion of an inflammatory nature.

A long period of COPD is inevitably accompanied by the development of bilateral pulmonary emphysema, as evidenced by the appearance of expiratory shortness of breath, that is, difficulty breathing in the “exhalation” phase. A characteristic feature of shortness of breath in COPD is its constant nature with a tendency to progress in the absence of therapeutic measures. The appearance of constant headaches without clear localization in the patient, dizziness, decreased ability to work and drowsiness indicate the development of hypoxic and hypercapnic damage to brain structures.

Medical Research Council (MRC) Dyspnea Scale:

The intensity of these manifestations varies from stability to exacerbation, during which the severity of shortness of breath increases, the volume of sputum and the intensity of cough increase, the viscosity and nature of the sputum discharge changes. The progression of the pathology is uneven, but gradually the patient’s condition worsens, and extrapulmonary symptoms and complications appear.

Diagnosis of COPD: stages

It is customary to distinguish several stages.

The beginning of the pathology is zero. It is characterized by the production of sputum in large volumes, the person coughs regularly. Lung function at this stage of the disease is preserved.

The first stage is the period of development of the disease during which the patient chronically coughs. The lungs regularly produce large volumes of mucus. Examination of the respiratory system reveals minor obstruction.

If a moderate form of the disease is diagnosed, it is distinguished by clinical symptoms (described earlier) that appear during physical activity.

A diagnosis of COPD, stage three, means that breathing failure has become life-threatening. With this form of the disease, the so-called “pulmonary heart” appears. Obvious manifestations of the disease: restriction of air flow when exhaling, shortness of breath is frequent and severe. In some cases, bronchial obstruction is observed, which is typical for an extremely severe form of the pathology. This is dangerous for human life.

Drug therapy

Medicines are the basis of treatment for COPD of any severity. Several groups of drugs are used: bronchodilators, mucolytics, glucocorticosteroids, antibiotics, antioxidants, immunoregulators.

Bronchodilators

Such medications are also called bronchodilators or bronchodilators.

Principles of bronchodilator therapy for COPD:

1. Bronchodilators are best administered by inhalation . This ensures direct penetration of the active substance into the bronchi, unlike tablets or powdered preparations (ACC, Fluimucil).
2. Long-acting inhaled bronchodilators are more expensive, but they are more convenient to use than short-acting ones.
3. For moderate and extremely severe COPD, systematic therapy with long-acting bronchodilators is recommended.
4. Positive dynamics in lung function after short-term use of bronchodilators does not serve as an indicator of their effectiveness with prolonged use.
5. The simultaneous administration of several bronchial dilators reduces the risk of side effects and increases the effectiveness of therapy compared to treatment with only one drug.
6. Elderly patients suffering from heart and vascular diseases should be treated with anticholinergics. This is explained by the fact that theophylline, anticholinergics and β2-adrenergic agonists have different availability, and individual sensitivity of patients to their effects .
7. When prescribing xanthines, the level of theophylline in the patient's blood should be measured, as side effects may develop during treatment.
   Despite this, such drugs are effective in the treatment of COPD. Important! Only theophyllines over a long period of exposure have a beneficial effect on lung function in COLD. But this does not apply to Theophedrine and Eufillin.
8. When treating with chonolitics and β2-adrenomimetics and anticholinergics, nebulizers, powder inhalers and metered-dose aerosols are used.

Atrovent

The drug belongs to the group of bronchodilators (m-anticholinergic). Available in the form of an aerosol, powder in capsules or solution for inhalation. Atrovent is available in the form of an aerosol for injection into the nose.

The main active ingredient , ipratropium bromide, promotes dilation of the bronchi and relaxes their muscles. The drug reduces the production of mucus in the bronchi without interfering with the discharge of sputum. It has a local effect, when inhaled into the bronchi it reaches 10% of the drug , the remaining amount of the drug remains in the mouth. The result of using Atrovent appears a maximum of a quarter of an hour after injection, peak effectiveness is observed after an hour and a half and lasts up to 8 hours.

Important! There is no clear answer as to which form of the drug is preferable for the treatment of COPD. When choosing, you should take into account the patient’s health status, age, conditions and situations where the drug will be used. All forms of Atrovent have advantages and disadvantages.

Analogues: Troventola, Ipravent, Truvent, Ipramol Steri-Sky, Spiriva.

Attention! If there is no improvement 30 minutes after using Atrovent, you should notify your doctor. You cannot independently increase the dose recommended by the doctor. If you have existing eye diseases, it is unacceptable for medication to get into them. Atroven contains benzalkonium chloride, which causes constriction of the bronchi.

Spiriva

The drug has a bronchodilator and anticholinergic effect and is used in the treatment of patients with COPD to prevent relapses of the disease.

Half an hour after inhalation, lung function increases, the effect lasts throughout the day . A pronounced bronchodilator effect is achieved on the third day of use, while tolerance to the drug was not observed within one year of use. The use of the drug reduces the number of COPD relapses and hospitalizations.

Analogues: Ipravent, Ipratropium, Sibri Breezhaler, Atrovent.

Attention! Spiriva is not used as a therapeutic agent for acute bronchospasm attacks. Do not allow the drug to come into contact with the eyes.

Modern drugs that have a pronounced positive effect after 28 days of use are Fenspiride or Erespal . They simultaneously act as anti-inflammatory, bronchodilator and antihistamine agents.

Fenspiride

Antitussive, bronchodilator and anti-inflammatory agent.

Analogues: Epistat, Erispirus.

Erespal

The drug limits the spread of inflammation , suppresses the production of viscous mucus in the body.

Important! Erespal cannot serve as a substitute for antibiotic therapy.

Mucolytics

Carbocesteine ​​and Ambroxol significantly facilitate sputum separation in patients and have a beneficial effect on overall health.

Carbocesteine

The drug reduces cough, accelerates the restoration of mucous membranes, and normalizes their structure.

Important! Carbocesteine ​​increases the effectiveness of Theophylline and antibacterial therapy.

Analogues: Bronkatar, Mukosol, Mukopront, Fluditek.

Ambroxol

The drug thins mucus and has expectorant and secretomotor properties. Ambroxol is available in the form of tablets - effervescent and prolonged action, capsules, syrup, solution intended for inhalation.

The effect of the drug develops 30 minutes after use and lasts for 12 hours.

Attention! Ambroxol should not be taken for more than 5 days. A longer course should be prescribed by a doctor.

Analogues: Lazolvan, Flavamed, Ambrobene.

Mass use of mucolytics in patients with COPD is not recommended; such drugs can be prescribed only to a small number of patients whose sputum is highly viscous.

Glucocorticosteroids

Such drugs have a pronounced anti-inflammatory effect , but in patients with COPD it is less pronounced than in asthmatics.

Important! Glucocorticosteroids should not be used for a long time, as there is a risk of osteoporosis or myopathy. For relapses of COPD, short courses lasting 10-14 days are required.

Fluticasone

The drug has anti-inflammatory, antipruritic, anti-edematous and antihistamine properties. Available in the form of ointment, nasal spray, and inhalation aerosol.

Inhalation causes the accumulation of 20% of the administered dose in the lungs, the rest enters the gastrointestinal tract and is metabolized in the liver to form an inactive form.

Budesonide

A hormonal drug available in the form of powder for inhalation. The active substance is an analogue of cortisol, which regulates the metabolism of minerals and carbohydrates in the body. The drug relieves inflammation and eliminates allergy symptoms.

The effect of the drug appears on days 5-7 of the course.

Antibiotics

Currently, there are no research results that would reliably confirm the reduction in frequency and beneficial effect on the severity of relapses of non-infectious COPD due to antibiotic therapy. Antibacterial drugs are recommended for the treatment of relapses of an infectious nature and eliminate the symptoms of COPD.

Important! The duration of antibiotic therapy should not exceed 15 days.

Antioxidants

They are actively used in the treatment of COPD for several reasons. For example, the drug Acetylcesteine ​​prolongs periods of remission and significantly reduces the number of exacerbations; the drug is used simultaneously with glucocorticoids and bronchodilators.

Acetylcesteine

The product facilitates the discharge of sputum, dilutes it and increases its volume. Has anti-inflammatory properties.

Immunoregulators

Otherwise they are called immunostimulants or immunomodulators. The systematic use of such drugs is not recommended, since there is no convincing evidence of their effectiveness. Patients who develop COPD before the age of forty can undergo a course of replacement therapy. Such treatment is not available everywhere in the world and is very expensive.

Principles of therapy

Modern treatment of COPD implies an individual approach to each patient depending on the clinical picture of the disease, complications, concomitant pathologies, as well as taking into account remission or relapse of the disease.

The goal of therapy is to solve several problems:

• slowing down the progression of the disease;
• relief of symptoms;
• increasing the vital capacity of the lungs, increasing the patient’s ability to work;
• preventing consequences and eliminating existing complications;
• preventing exacerbations and getting rid of relapses;
• warning of death.

Treatment measures will give a positive result only if the following conditions are met:

• to give up smoking. For this, certain medications are used;
• exclusion of provoking factors of the disease;
• carrying out adequate and effective drug therapy: basic treatment during remission, as well as the use of systemic drugs during relapses;
• if respiratory failure occurs, oxygen therapy is mandatory;
• surgical intervention in severe cases.

The use of medications for chronic obstructive pulmonary disease is one of the main conditions for effective treatment. Only medications will help eliminate inflammatory processes, suppress infection, and get rid of bronchospasm.

Basic treatment

Typically, doctors use staged treatment, which involves the use of various techniques and medications.

Basic therapy is based on measures that prevent attacks and improve the general well-being of the patient. For this purpose, certain medications and clinical monitoring of the patient are used. In addition, the patient is explained the need to give up bad habits that provoke an exacerbation of the pathology.

• Basic drug therapy consists of the use of bronchodilators and glucocorticoids, including long-term effects.
• Along with medications, breathing exercises are used to increase pulmonary endurance.
• In addition, it is necessary to monitor proper nutrition, get rid of excess body weight, and enrich the body with vitamins.

As a rule, the treatment of COPD in elderly people, as well as in the severe stage of obstruction, has some difficulties: most often the pathology is accompanied by concomitant diseases, reduced immunity and complications. In this case, patients need constant care, as well as oxygen therapy, which will prevent hypoxia and attacks of suffocation. If the lung tissue has undergone significant changes, surgery to remove part of the lung (resection) is indicated. If a tumor is detected, radiofrequency ablation is performed.

In most cases, the patient seeks medical help in advanced stages, when therapeutic measures no longer lead to a positive effect.

Treatment of moderate COPD

First of all, treatment measures should be aimed at reducing the impact of negative factors, including quitting smoking. Together with this, drug and non-drug treatment is used. The combination of remedies depends on the general state of health, as well as on the phase of the disease - the stage of improvement or exacerbation:

• Regular or periodic use of bronchodilators will help slow down the obstructive process in the bronchi.
• Inhalations for COPD with glucocorticoids will relieve exacerbations, and can be used simultaneously with long-term adrenergic agonists. These drugs in combination have a positive effect on lung function.

At this stage, it is not recommended to take glucocorticoids in tablets for a long time, as they can provoke negative consequences.

At the second stage of the disease, physical therapy is prescribed, which will increase the patient’s resistance to physical activity, reduce shortness of breath and fatigue.

Treatment of severe disease

The third stage of the disease requires intensification of ongoing therapeutic measures and the use of anti-inflammatory drugs on an ongoing basis:

• Patients are prescribed glucocorticosteroids (Pulmicort, Beclazone, Becotide, Benacort, Flixotide) by inhalation using a nebulizer.
• In severe cases, combined bronchodilators (Seretide, Symbicort) are indicated. They have a long-lasting effect and can be combined with each other.

You should not use several medications at the same time on your own. Improper inhalation can reduce the therapeutic effect of drugs and cause side effects.

Relapse of COPD

An exacerbation of the disease can occur suddenly under the influence of various unfavorable factors, external stimuli, physiological and emotional reasons. In some patients, a relapse can develop even after eating, and manifest itself in the form of suffocation and deterioration of the general condition.

Sharp exacerbations of the disease can occur several times a year, which is why every patient needs to know about measures to prevent them.

Symptoms of exacerbation of COPD may include:

• increased cough, increased intensity;
• shortness of breath even at rest;
• the appearance of mucous discharge with pus when coughing;
• increased sputum production;
• wheezing in the lungs, which can be heard even at a distance;
• tinnitus, headache, dizziness;
• sleep disorder;
• soreness in the heart;
• cold hands and feet.

During a relapse, the patient requires emergency care. In this case, it is necessary to urgently relieve an attack of suffocation and shortness of breath, so all patients are recommended to always have an inhaler or spacer with them, which will help restore respiratory function . In addition, it is necessary to take care of the flow of fresh air.

The drugs Atrovent, Salbutamol and Berodual have a quick effect.

If there is no relief from the measures taken, you should immediately call an ambulance.

In inpatient settings, therapy is carried out according to a certain scheme:

• To relieve an attack of suffocation, bronchodilator drugs are used with a double dosage of short-acting action, with an increase in frequency and their use.
• If there is no result, Eufillin is administered intravenously.
• Beta-adrenergic stimulants together with anticholinergic drugs will help eliminate bronchospasm.
• If there are purulent impurities in the mucus, antibiotic therapy with drugs of a wide spectrum of activity is indicated.
• In some situations, glucocorticosteroids are prescribed by inhalation, injection, and tablets (Prednisolone).
• When there is a marked decrease in oxygen saturation, oxygen therapy is used.

If the obstruction is caused by other diseases, medications are prescribed to eliminate them.

The use of traditional medicine during a relapse may not lead to the desired effect and worsen the patient’s condition.

Features of nutrition and lifestyle

The most important component of treatment is the elimination of provoking factors, for example, smoking or leaving a hazardous workplace. If this is not done, the entire treatment will be practically useless.

To quit smoking, you can use acupuncture, nicotine replacement medications (patches, chewing gum), etc. Due to the tendency of patients to lose weight, adequate protein nutrition is necessary. That is, the daily diet must include meat products and/or fish dishes, fermented milk products and cottage cheese. Due to developing shortness of breath, many patients try to avoid physical activity. This is fundamentally wrong. Daily physical activity is necessary. For example, daily walks at a pace that your condition allows. Breathing exercises, for example, according to Strelnikova’s method, have a very good effect.

Every day, 5-6 times a day, you need to do exercises that stimulate diaphragmatic breathing. To do this, you need to sit down, put your hand on your stomach to control the process and breathe with your stomach. Spend 5-6 minutes on this procedure at a time. This method of breathing helps to use the entire volume of the lungs and strengthen the respiratory muscles. Diaphragmatic breathing may also help reduce shortness of breath during exercise.

Conclusion

What is the result of these methods of predicting life expectancy? The more you can do, the better, to avoid progressing to a higher level of COPD. The best way to slow the progression of the disease is to quit smoking if you smoke. Also avoid secondhand smoke or other irritants such as air pollution, dust or chemicals.

If you are underweight, it is helpful to maintain your weight with good nutrition and techniques to increase your food intake, such as taking small, frequent meals. Learning how to improve your breathing through exercises such as pursed lip breathing will also help.

Participation in a pulmonary rehabilitation program is also important. You'll learn exercises, breathing techniques, and other strategies to maximize your health. And while exercise and physical activity can be challenging with a breathing disorder, it's one of the best things you can do for the health of your lungs and the rest of your body.

Talk to your doctor about the safest way to start exercising. And learn the warning signs of breathing problems and what you should do if you experience a flare-up or minor flare-up.

The more you can improve your health, the longer and fuller your life can be.

Causes

The main cause of COPD is smoking, active and passive. Tobacco smoke damages the bronchi and the lung tissue itself, causing inflammation. Only 10% of cases of the disease are associated with the influence of occupational hazards and constant air pollution. Genetic factors may also be involved in the development of the disease, causing a deficiency of certain lung-protecting substances.

Main risk factors for COPD:

Caring for terminally ill patients

In severe stages of the disease, when death is inevitable, physical activity is undesirable and daily activity is aimed at minimizing energy costs. For example, patients can limit their living space to one floor of the house, eat more often and in small portions, rather than rarely and in large quantities, and avoid tight shoes.

Care of terminally ill patients should be discussed, including the inevitability of mechanical ventilation, the use of temporary pain-relieving sedatives, and the designation of a medical decision maker in the event of a patient's disability.