COPD and respiratory disorders Flashcards
What is chronic obstructive pulmonary disease (COPD)?
(Asthma and Lung UK, 2022)
- used to describe group of diseases that cause airflow blockage and breathing-related problems that cannot be cured or reversed, including emphysema and chronic bronchitis
- these impact quality of life and lead to life threatening conditions
-140,000 people diagnosed with COPD in Scotland
What are the causes of COPD?
Jones (2015)
- smoking, accounts for 80%
- long term exposure to harmful fumes or dust (e.g. welding fumes, grain and flour dust, coal etc)
- long term exposure to air pollution
- genetics: people with higher aplha-1-antitrypsin defeciency have increased risk of COPD. Aplha-1-antitrypsin is a substance produced in the liver that protects the lungs
Whats the difference between emphysema and chronic bronchitis?
(NHS, 2023)
Emphysema affects the air sacs (alveoli) in your lungs by breaking down the membrane. Irritants are inhaled and become trapped in the alveoli, triggering an inflammatory response. This then causes alveoli to swell, causing the walls to get thinner and eventually dissolve meaning the exchange of O2 and CO2 becomes less efficient and becomes trapped.
Chronic bronchitis affects your airways making them inflammed and secrete excess mucus causing airways in your lungs, your bronchi, become inflamed causing severe coughing spells that bring up mucus, wheezing, chest pain and shortness of breath.
With COPD, your airways become inflamed and the air sacs in your lungs are damaged.
This causes your airways to become narrower, which makes it harder to breathe in and out. These breathing difficulties can affect many aspects of your daily life.
What are the symptoms of COPD?
(NHS, 2023)
- Increasing breathlessness
- persistent chesty cough with phlegm that does not go away
- frequenct chest infections
- persistent wheezing
- chest tightness
- swelling in ankles, feet, or legs
- lack of energy
- weight loss in later stages
- barrel shaped chest- later stages- as lungs are chonically overfilled with air and cant deflate normally, causing ribcage to be expanded at all times
How is COPD diagnosed?
(Asthma and Lung UK, 2022)
- self-assessment tools: COPD assessment test (CAT), modified medical research council dyspnea scale (mMRS breathlessness), Asthma-COPD overlap syndrome (ACOS)
- spirometry- measures the volume of air you can breathe out in a second, and the total amount of air you breathe out. the readings are compared with normal results for your age to show if airways are obstructed
- chest X-ray- used to look for other problems in the lungs that can cause similar symptoms to COPD.
- blood test- to see if you have alpha-1-antitrypsin deficiency
How is COPD managed?
(NHS Inform, 2023)
Stopping smoking is the easiest way to manage COPD and preventing worsening.
Getting vaccinated reduced the risk of complications from other illnesses e.g. pneumonia, influenza
STEPWISE: use the lowest step that acheives optimal control based on the COPD severtiy. Starts with short acting anti-muscarinic (SAMA) and beta agonist (SABA) mono therapy, then increases to combination for symptom relief.
It then increases to long-acting anti-muscarinic (LAMA) or long-acting beta agonist (LABA) mono therapy or combination for symptom relief and prevention of worsening.
then increasing to triple therapy LAMA, LABA, and ICS (inhaled cortiocosteriod) to prevent further worsening.
What medications are used to treat COPD?
(NHS Inform, 2023)
Short-acting bronchodilator: 4 times a day, lasts 4-6 hours, works quickly.
Long-acting bronchodilator:
one or twice a day, lasts 12-24 hours, takes longer to work
There are two main types of long-acting drugs:
- long-acting anti-muscarinic (LAMA)
-long-acting beta agonist (LABA).
May benefit from taking both kinds, maybe in a combination.
* steriod inhalers
* nebulisers
* bronchodilators
What therapies are used to treat COPD?
(Asthma and Lung UK, 2022)
- pulmonary rehabilitation: a exercise and education programme- offers dietary advice, psychological and emotional support, education about medication or breathing techniques, and physical exercies tailored to needs and ability
- oxygen therapies: only used in people with low oxygen level as doesnt help with breathlessness
- non-invasive ventilation: masks fitted over the nose and mouth to get air into the lungs, supporting breathing out carbon dioxide and giving the muscles a rest
- surgeries:
lung- volume reduction to reduce the amount of air trapped in the luncgs by removing damaged lung or putting valves into the airway
lung transplant
What is asthma?
(Asthma and Lung UK, 2022)
- major NCD affecting children and adults
- most common chronic disease among children
- in 2019 it affected an estimated 262 million people and caused 455,000 deaths
What are the risk factors associated with asthma?
(NHS, 2023)
- family history
- diagnosed with another allergic condition
- obesity
- smoking
- exposure to secondhard smoke, pollution, or exhaust fumes
- exposure to occupational triggers e.g. chemicals, fumes
How does asthma impact the airways?
(Preston and Kelly, 2017).
asthmatic airways have thickened and inflamed walls.
during an asthma attack, the smooth muscle of the airways tighten causing air to become trapped in alveoli.
What are the symptoms of asthma?
(Asthma and Lung UK, 2022)
- coughing
- wheezing
- shortness of breath
- chest tighness
- runny nose
- excess mucus
- itchy eyes and throat
- substernal retraction
- tracheal tug
What are the four different classifications of asthma?
(Asthma and Lung UK, 2022)
mild intermittent- mild symptoms up to 2 days a week and 2 nights a month
mild perisstent- symptoms more than twice a week, but no more than once a day
moderate persistent- symptoms once a day and more than one night a week
severe persistent- symptoms throughout the day most days and frequenlty at night
How is asthma diagnosed?
(Asthma and Lung UK, 2022)
- physical exam
- lung function tests like:
- spirometry to determine the degree of broncial tube narrowing
- peak flow- how hard a patient can breathe out
- allergy tests
- imaging tests to look for structural abnormalities
How is asthma treated?
(Asthma and Lung UK, 2022)
- reliever inhalers- releive symptoms
- preventor inhalers- reduce inflammation and sensitivity of the airways
- combination inhalers
- tablets e.g. steroids to reduce inflammation in airways or leukotriene receptor antagonist (LTRA) to also reduce inflammtion
- injections if tablets arent working
- surgery
