CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) 5
ChronicObstructive Pulmonary Disease (COPD)
ChronicObstructive Pulmonary Disease (COPD)
COPDconstitutes illnesses that affect the functioning of the lungs andprimarily characterized by difficulties in breathing alongside othersymptoms related to respiratory diseases such as wheezing andcoughing. Although COPD is mostly associated with smoking,non-smokers are also susceptible to contracting the disease. The 2017report by GOLD posits that COPD ranks high among the causes of deathsglobally due to exposure to risk factors and old age. Projectionsshow that in the next three years, many people are likely to succumbto COPD. Since COPD is treatable and preventable, GOLD’s reportdocuments strategies for identification, management, and preventionof the disease to guide the clinicians in the treatment of COPD andprevent future mortalities and comorbidities. This essay examines thetenets of the COPD’s strategies and relates them to the case of Mr.Pat misdiagnosed for asthma and a decade later diagnosed with COPD,rendering a change in his medication.
Accordingto GOLD (2017), COPD diagnosis entails the assessment of symptoms,risk factors, and conducting a spirometry test. Symptoms associatedwith COPD are dyspnea, productive or unproductive chronic cough,sputum production, wheezing, and chest tightness. The risk factorslook into the medical history of an individual of tobacco smokethrough smoking or environmental exposure, previous history ofrespiratory diseases and a family history of chronic respiratoryillnesses or COPD. Physical examination of airflow limitation mightdiagnose COPD, but the signs are not detected early until the lungssuffer major impairment. Finally, spirometry is the sure test ofconfirming COPD that measures the ratio of the volume of air exhaledin one second (FEV1)and air exhaled forcibly in maximal inspiration (FVC). If FEV1/FVC<0.70, then one has an obstructive disease.
Pulmonaryrehabilitation is one of the management techniques of COPD. Itinvolves educating patients on smoking cessation, when to seekmedical interventions, and correct use of medication to influencebehavior change. Self-management initiatives tailored to a healthfacility engage and motivate patients to embrace healthy habits.Well-structured, individualized, and integrated care programs assistthe patient to manage the illness. Smoking cessation remains theleading COPD prevention strategy. Pharmacotherapy through Nicotinereplacement products such as e-cigarettes and pharmacologic productspromote smoking abstinence, while Influenza and Pneumococcal vaccinesreduce the susceptibility of chronic respiratory diseases(GOLD, 2017).
Besidesthe symptoms and the risk factors of COPD, a clinical officer shouldconduct a spirometry test to diagnose an obstructive disease becausenot all cigarette smokers contract COPD. Also, chronic coughs andwheezing might be due to Asthma, which is not a COPD. Spirometryshould meet the set standards where the volume/time of air should beunbiased with a less than a second pause between inhalation andexhalation. The spirometry results are taken from the higher valuesof FVC and FEV1andcompared to age, sex, and height(GOLD, 2017).The health care provider should keep a database of chronicrespiratory patients to give then the influenza vaccine. The provideroffers patient education on diagnosis about overall treatment plans,and drug therapy(Woo & Robinson, 2015).The clinicians should also focus on smoking cessation initiatives byapplying pharmacological interventions, explain the role ofmedication in patients, and use medication skills such as writtenschedules to older patients to assist them to take medication on theprescribed routine.
Initially,Pat Crowe lived an active life playing cricket and football, but atthe age of 39, he could no longer participate in the games because ofincessant gasping, wheezing, coughing and feeling torpid (Lee, 2013).Although he was diagnosed with Asthma, he experienced a constrictionof the lung airways throughout, unlike towards an allergic reaction,and the inhalers did not suppress the condition. Thus, ruling out thepossibility of Pat being Asthmatic. Looking into the risk factors, hehad worked as a coal miner, an indication that he inhaled fine coalparticles that interfered with the lung air passages. From inception,Pat needed a pulmonary function test. Eleven years later, heundergoes spirometry. The spirometric results were FEV1/FVC<70%, a confirmation that Pat had COPD. He suffers from AcuteBronchitis.
Basedon Pat’s medical history of the chronic respiratory disease, he hasnever encountered any exacerbations. It implies that he has anonfrequent exacerbator COPD phenotype. As such, bronchodilatortreatment can stabilize the COPD (Montuschi, Malerba, Santini, &Miravitlles, 2014). In addition, a personalized managementpharmacotherapy approach would ensure that Pat adopts skills tomanage Acute Bronchitis such as managing breathlessness, maintaininga closer relationship with the clinician, and avoiding triggerfactors such as environmental or occupational exposure.
Inconclusion, it is evident that COPD is a life-threatening conditionthat requires additional attention from health professionals todownplay incidences of misdiagnosis or poor disease management. It iscommendable that GOLD has documented approaches that should be usedin a clinical setting for correct diagnosis, management, andprevention of COPD. It guarantees that if clinicians adopt thestrategies, mortality, morbidity, and comorbidity rates of COPD willdecline significantly. As such, incidences of incorrectidentification of a disease like that of Pat are unlikely to occur.
GlobalInitiative for Chronic Obstructive Lung Disease (GOLD), Inc. (2017).GlobalStrategy for the Diagnosis, Management, and Prevention of ChronicObstructive Pulmonary Disease (2017 Report).Global Initiative for Chronic Obstructive Lung Disease, Inc.
Lee,C. (2013, July 29). ThePatients Palmed off with an Inhaler When They`ve got a killer lungDisease.Retrieved March 28, 2017, from Daily Mail:http://www.dailymail.co.uk/health/article-2381072/COPD-patients-palmed-inhaler-theyve-got-killer-lung-disease.html
Montuschi,P., Malerba, M., Santini, G., & Miravitlles, M. (2014).Pharmacological treatment of chronic obstructive pulmonary disease:from evidence-based medicine to phenotyping. Drugdiscovery today, 19(12),1928-1935.
Woo,T. M., & Robinson, M. V. (2015). PharmacotherapeuticsFor Advanced Practice Nurse Prescribers.F.A. Davis.