COPD, complications and pharmaceutical therapies.

Complication

Chronic obstructive pulmonary disease is serious and debilitating health problem. It runs a long course to cause severe damage to your lungs. Its diagnosis and treatment usually starts when it has already caused secondary complication to your cardio respiratory system. Your lung capacity is markedly diminished as well as life routine compromised. The complication can be life threatening if exposure to causative agents is not avoided and supportive treatment not taken. Following secondary effects of  COPD may endanger your life;

Ÿ  Pulmonary hypertension arises when your lungs loose elasticity along with constriction and hardening of its blood vessels as result of COPD. Heart faces greater resistance to push blood into pulmonary artery, through your lung vessels. Ultimately oxygenation of blood is reduced.

Ÿ  Pneumonia of both viral and bacterial cause may readily effect you in COPD. The dual effect of reduced oxygenation and excessive mucus in airways makes your lungs more susceptible to infection by such organisms. Deterioration in your health due to COPD hampers or minimizes your immunity. Pneumonia further damages your lung tissue which is already facing restrictive effects of COPD, thereby creating a vicious cycle.

Ÿ  Cor Pulmonale is failure of right side of your heart due to chronic obstructive pulmonary disease. There is increased resistance faced by right ventricle of your heart in pumping blood through lungs. Pulmonary artery pressure rises and ultimately results slow pumping, lesser blood flow to lungs and breathing strain. Right ventricle enlarges and fail to work efficiently.

Ÿ  Polycythemia (increased red cells in blood) occurs due to reduced oxygen saturation of blood. It stimulates your bone marrow to produce increased number of red blood cells. This is mediated via erythropoietin(hormone for red cell production) release from your kidneys. The objective is to compensate reduced oxygen supply to your body cells as complication of COPD sets in.

Ÿ  Malnutrition and weight loss is very common when you have established COPD. The dyspnea (difficulty in breathing) is so troublesome that will make it hard for you to complete a meal. You may gradually start loosing weight. This further effects your body strength to carry out routine life activities.

Ÿ  Pneumothorax is presence of air between your lungs and chest wall. The over inflated air sacs in emphysema (COPD variant) may burst with result in escape of trapped air into chest cavity. This complicates into collapse of your lung if that air is not immediately removed from you chest wall through intubation.

Pharmaceutical therapies

The damage your smoking has caused during long term is irreversible. Any treatment at this stage will be supportive and not curative. The medicine and other modalities will halt progression of damage, enhance your strength needed for daily life activities to better extent. Following are medication that will be prescribed when you are diagnosed with COPD.

                                                                            Bronchodilator inhalers

                                                  

Ÿ  Bronchodilators,  are group of drugs that will relax and expand the constricted and narrowed respiratory passages. They can be taken orally, by injections or as aerosols/inhalers. The inhalation route of bronchodilators is much preferred as it effectively reaches the narrowed airways directly with immediate effects. Also the side effects associated with drugs are minimal. A combination inhaler of fluticasone and salmeterol is one of popular inhalers for COPD. Another inhaler to be prescribed contains formotorol and budesonide. They all have corticosteroids and long acting b agaonist bronchodilator. You may be given oral long or short acting beta agonist like albuterol, turbutaline, salmeterol, bambuterol, formoterol.

Ÿ  Side effects of beta agonist agents include ; tachycardia(rapid heart rate), tremors, premature ventricular contractions, sleep disturbances, lowering of serum potassium.

Ÿ         Anti-cholinergic inhaler may also be given. Ipratopium is one of such kind. They all have proven efficacy in your COPD maintenance treatment. They also relax the smooth muscles of your airways and reduce mucus secretions. These agents improve your exercise tolerance and forced expiratory volume in one second. They are prescribed to you if you have some underlying cardiac problem. Side effects of anti-cholinergic are, dryness of mouth, increased intraocular pressure.

Ÿ  Methylxanthines are group of drugs that have some bronchodilator effect. They also make mucus expulsion easy and strengthen airways in some way. Theophyline(oral) and aminophyline(inject able) are two agents of this group used.

Ÿ  Side effects of methylxanthines are, irregular heart beats, convulsions, headache, nausea, vomiting, diarrhea and heart burns.

                                                       

Ÿ  Corticosteroids,   such as prednisone and prednisone are very effective anti-inflammatory group of drugs for your COPD. They bring satisfactory improvement in lung function in 30%-40% of COPD patients. They reduce inflammatory reaction, hall mark of swollen respiratory passages and excessive mucus.

Ÿ  Side effects are, osteoporosis( thinning of bones), raised blood pressure, disturbed sugar levels leading to diabetes on long term use, weight gain, loss of sleep.

Ÿ  Vaccination, to minimize risk of flu and pneumonia. Flu shots are better to be taken with full consultation of your healthcare provider as they have shown aggravation of COPD. Pneumoccocal vaccine also decreases you risk of pneumonia, which may complicate your COPD easily.

Ÿ  Oxygen therapy,  may be needed to bring improvement in its concentration in your airways. This is highly reduced in COPD. It can benefit in your daily activity. Also it will be preventing heart strain and damage to vital organs. It brings about improvement in your sleep and keeps your energy level high.

Ÿ  Anti-biotics,  also have an important role to play in controlling infection in your COPD. These infections easily can harm your lungs. In acute flare ups of your COPD, the number one choice is tromethoprim-sulphamethaxazole combination for five days. Other group also effective are ampicillin and tetracyclines for same duration. Azithromycin has also shown promising results in dealing infection in COPD.

Ÿ  Side effects of anti-biotics are common with gastrointestinal upsets, skin rashes, vomiting , nausea, abdominal pains. Some of them may cause anaphylaxis, a sudden and possible life threatening reaction drug.