14-09-2013, 04:50 PM
CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
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Definition:
COPD (chronic obstructive pulmonary disease) is a group of lung diseases that cause obstruction of the airways. this results in a decreased ability to move air in and out of the lungs.
diseases classified under the heading of copd include emphysema, chronic bronchitis
Emphysema:
Emphysema is among a group of lung diseases known as COPD, in which the alveoli of the lungs become damaged, causing them to enlarge and burst. Because the alveoli are where oxygen and carbon dioxide are exchanged, damage to this area makes it difficult for people with emphysema to expel all their air. This causes a build up of carbon dioxide in the body.
There are 4 types of emphysema:
Centriacinar / centrilobular: proximal to central parts of acini (air spaces closer to bronchioles) are affected
Panacinar / panlobular: enlargement of all air spaces (from bronchioles to terminal blind alveoli). This type is associated with alpha-1-antitrypsin deficiency
Distal acinar / paraseptal: proximal acinus normal, distal acinus affected
Irregular: various parts of acinus involved. Associated with fibrosis.
Chronic bronchitis:
Lung damage and inflammation in the large airways results in chronic bronchitis.
Chronic bronchitis is defined in clinical terms as a cough with sputum production on most days for 3 months of a year, for 2 consecutive years.
RISK FACTORS FOR COPD
Host Factors
Genes (alpha1- anti-trypsin↓)
Hyper responsiveness
Lung growth, low BW, Age
Exposure
Tobacco smoke,
Bio mass fuel smoke, open fires
Occupational dusts and chemicals
Chronic uncontrolled asthma
Infections, overcrowding, damp
Low socioeconomic status
Low dietary vegetable and fruit intake
Treatment of COPD
Smoking cessation
Antibiotics and vaccines
Eg: amoxicillin, doxycycline, erythromycin
Bronchodilators
a)inhaled β2 agonist: salmeterol
b)anticholinergics: ipratropium
c) theophyllines
Corticosteroids