The Pharmacotherapy of Chronic Obstructive Pulmonary Disease in the Elderly: An Update

2011 ◽  
Vol 3 ◽  
pp. CMT.S3408
Author(s):  
Hashir Majid ◽  
Amir Sharafkhaneh
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
The Elderly ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Age Group ◽  
Optimal Management ◽  
Average Life ◽  
Obstructive Pulmonary Disease ◽  
Average Life Span

Chronic obstructive pulmonary disease (COPD) is a disorder of the airways characterized by inflammation and airflow limitation. It is a major cause of morbidity and mortality globally and its prevalence is on the rise. COPD is predominantly a disease of the older age group. As the average life-span increases world-wide, and the burden of COPD increases, correct recognition and optimal management of this disease has become essential in the elderly. In the proceeding article, changes in the respiratory system associated with normal aging, as well as with COPD are reviewed. Important implications of aging in COPD management are also discussed.

scholarly journals Cognitive Impairment in Chronic Obstructive Pulmonary Disease (COPD): Possible Utility of Marine Bioactive Compounds

Marine Drugs ◽  
2018 ◽  
Vol 16 (9) ◽  
pp. 313
Author(s):  
Giulia Prinzi ◽  
Alessia Santoro ◽  
Palma Lamonaca ◽  
Vittorio Cardaci ◽  
Massimo Fini ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cognitive Impairment ◽  
Pulmonary Disease ◽  
Bioactive Compounds ◽  
Daily Living ◽  
The Elderly ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is characterized by long-term airflow limitation. Early-onset COPD in non-smoker subjects is ≥60 years and in the elderly is often associated with different comorbidities. Cognitive impairment is one of the most common feature in patients with COPD, and is associated with COPD severity and comorbidities. Cognitive impairment in COPD enhances the assistance requirement in different aspects of daily living, treatment adherence, and effectual self-management.This review describes various bioactive compounds of natural marine sources that modulate different targets shared by both COPD and cognitive impairment and hypothesizes a possible link between these two syndromes.

scholarly journals COPD Guidelines in the Asia-Pacific Regions: Similarities and Differences

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1153
Author(s):  
Shih-Lung Cheng ◽  
Ching-Hsiung Lin
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Global Strategy ◽  
Airflow Limitation ◽  
Asia Pacific ◽  
Pharmacologic Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Country Level ◽  
Similarities And Differences

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that is associated with significant morbidity and mortality, giving rise to an enormous social and economic burden. The Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD) report is one of the most frequently used documents for managing COPD patients worldwide. A survey was conducted across country-level members of Asia-Pacific Society of Respiratory (APSR) for collecting an updated version of local COPD guidelines, which were implemented in each country. This is the first report to summarize the similarities and differences among the COPD guidelines across the Asia-Pacific region. The degree of airflow limitation, assessment of COPD severity, management, and pharmacologic therapy of stable COPD will be reviewed in this report.

scholarly journals Alternative methods for assessing bronchodilator reversibility in chronic obstructive pulmonary disease

Thorax ◽  
2001 ◽  
Vol 56 (9) ◽  
pp. 713-720
Author(s):  
J Hadcroft ◽  
P M A Calverley
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Lung Volume ◽  
Tidal Flow ◽  
Airflow Limitation ◽  
Alternative Methods ◽  
Chronic Obstructive ◽  
Flow Limitation ◽  
Inspiratory Capacity ◽  
Obstructive Pulmonary Disease

BACKGROUNDBronchodilator reversibility testing is recommended in all patients with chronic obstructive pulmonary disease (COPD) but does not predict improvements in breathlessness or exercise performance. Two alternative ways of assessing lung mechanics—measurement of end expiratory lung volume (EELV) using the inspiratory capacity manoeuvre and application of negative expiratory pressure (NEP) during tidal breathing to detect tidal airflow limitation—do relate to the degree of breathlessness in COPD. Their usefulness as end points in bronchodilator reversibility testing has not been examined.METHODSWe studied 20 patients with clinically stable COPD (mean age 69.9 (1.5) years, 15 men, forced expiratory volume in one second (FEV1) 29.5 (1.6)% predicted) with tidal flow limitation as assessed by their maximum flow-volume loop. Spirometric parameters, slow vital capacity (SVC), inspiratory capacity (IC), and NEP were measured seated, before and after nebulised saline, and at intervals after 5 mg nebulised salbutamol and 500 μg nebulised ipratropium bromide. The patients attended twice and the treatment order was randomised.RESULTSMean FEV1, FVC, SVC, and IC were unchanged after saline but the degree of tidal flow limitation varied. FEV1 improved significantly after salbutamol and ipratropium (0.11 (0.02) l and 0.09 (0.02) l, respectively) as did the other lung volumes with further significant increases after the combination. Tidal volume and mean expiratory flow increased significantly after all bronchodilators but breathlessness fell significantly only after the combination treatment. The initial NEP score was unrelated to subsequent changes in lung volume.CONCLUSIONSNEP is not an appropriate measurement of acute bronchodilator responsiveness. Changes in IC were significantly larger than those in FEV1and may be more easily detected. However, our data showed no evidence for separation of “reversible” and “irreversible” groups whatever outcome measure was adopted.

Ventilation-perfusion imbalance and chronic obstructive pulmonary disease staging severity

2009 ◽  
Vol 106 (6) ◽  
pp. 1902-1908 ◽  
Author(s):  
Roberto Rodríguez-Roisin ◽  
Mitra Drakulovic ◽  
Diego A. Rodríguez ◽  
Josep Roca ◽  
Joan Albert Barberà ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Gas Exchange ◽  
Pulmonary Disease ◽  
Forced Expiratory Volume ◽  
Pulmonary Gas Exchange ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
Stage 1

Chronic obstructive pulmonary disease (COPD) is characterized by a decline in forced expiratory volume in 1 s (FEV1) and, in many advanced patients, by arterial hypoxemia with or without hypercapnia. Spirometric and gas exchange abnormalities have not been found to relate closely, but this may reflect a narrow range of severity in patients studied. Therefore, we assessed the relationship between pulmonary gas exchange and airflow limitation in patients with COPD across the severity spectrum. Ventilation-perfusion (V̇A/Q̇) mismatch was measured using the multiple inert gas elimination technique in 150 patients from previous studies. The distribution of patients according to the GOLD stage of COPD was: 15 with stage 1; 40 with stage 2; 32 with stage 3; and 63 with stage 4. In GOLD stage 1, AaPo2 and V̇A/Q̇ mismatch were clearly abnormal; thereafter, hypoxemia, AaPo2, and V̇A/Q̇ imbalance increased, but the changes from GOLD stages 1–4 were modest. Postbronchodilator FEV1 was related to PaO2 ( r = 0.62) and PaCO2 ( r = −0.59) and to overall V̇A/Q̇ heterogeneity ( r = −0.48) ( P < 0.001 each). Pulmonary gas exchange abnormalities in COPD are related to FEV1 across the spectrum of severity. V̇A/Q̇ imbalance, predominantly perfusion heterogeneity, is disproportionately greater than airflow limitation in GOLD stage 1, suggesting that COPD initially involves the smallest airways, parenchyma, and pulmonary vessels with minimal spirometric disturbances. That progression of V̇A/Q̇ inequality with spirometric severity is modest may reflect pathogenic processes that reduce both local ventilation and blood flow in the same regions through airway and alveolar disease and capillary involvement.

scholarly journals A literature review on depression and its risk factors among people suffering from chronic obstructive pulmonary disease in Asian sub-continent

2020 ◽  
Vol 7 (11) ◽  
pp. 4653
Author(s):  
Amrit Sharma
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Low Income ◽  
Airflow Obstruction ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Inflammatory Response ◽  
Basic Activity

Chronic obstructive pulmonary disease (COPD) is defined as persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. It has been suggested that emotional disturbances such as depression and anxiety are common among patients with COPD. This review aims to highlight the presence of depression and associated risk factors among patients suffering from COPD in Asia. Fifty-eight observational studies were retrieved through data sources like PubMed, Medical subject heading (MeSH) search and Google scholar. After thorough screening total thirteen studies were identified and included in this review. Based on the results of these studies, the south and west Asian countries had higher proportion of depression. However, risk factor results were mixed which includes severity of obstruction/global initiative for obstructive lung disease (GOLD) criteria, Stage 2 COPD, teetotallers, smoking, alcohol consumption, body mass index, airflow obstruction, dyspnoea, and exercise (BODE) index, urban residence, female gender, education level, dyspnoea, low income, poor Quality of life (QOL) scores, age, poor self-reported health, basic activity of daily living (BADL) disability. Further superior research studies with larger sample size are required on Asian population. All in all, it is recommended that early diagnosis and treatment of depression should be included as a part of management in COPD as it can help to minimize the risk of morbidity and mortality in the patients.

scholarly journals Predictors of co-morbidities in chronic obstructive pulmonary disease patients at a tertiary care centre in north India

2019 ◽  
Vol 7 (11) ◽  
pp. 4154
Author(s):  
Kaushlendra Pratap Narayan ◽  
S. K. Verma ◽  
Surya Kant ◽  
R. A. S. Kushwaha ◽  
Santosh Kumar ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inflammatory Process ◽  
Tertiary Care ◽  
Airflow Limitation ◽  
Pulmonary Vasculature ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Co Morbidity

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. COPD is characterised by an intense inflammatory process in the airways, parenchyma, and pulmonary vasculature. It is possible in some cases that the inflammatory process may overflow into the systemic circulation, promoting a generalised inflammatory reaction. Patient with COPD often have concomitant chronic illness (co-morbidities). The aim of this study is to know the pattern of co-morbidities in COPD patients.Methods: This study was a cross sectional observational study conducted on 172 COPD patients (IPD and OPD) diagnosed on the basis of GOLD guideline 2017. Co morbidities were diagnosed as per standard defined criteria laid down in the respective guidelines.Results: 55.3% of the patients with COPD had co morbidities. 18/88(20.5%) patients presented with multiple co-morbidities. 49/88, 55.7% COPD patients were affected with cardiac (either only cardiac or had multiple organs affected besides cardiac), the commonest co-morbidity. Amongst cardiac, hypertension and congestive heart failure (CHF) was the commonest (n=19/49, 38.8% each) followed by CAD/CSA/IWMI/IHD/AF. Others were metabolic (n=14/88, 15.9%), GERD (n=13/88, 14.8%), Depression (n=11/88, 12.5%). Less prevalent co-morbidities were Osteoporosis (n=8/88, 9.1%), Lung cancer (n=6/88, 6.8%), Bronchiectasis (n=5/88, 5.6%) and OSA (n=3/88, 3.4%).Conclusions: Urban indwelling, advancing age and duration of illness, presentation with low mood, loss of pleasure/ interest, appetite disturbances and heart burn with relief on taking proton pump inhibitor can be predictors of co-morbidities in COPD patients. Chance of finding co-morbidities may be multifactorial. Thus, it is important to look out for co morbidities in each and every COPD patients.

LUNG FUNCTION IN SUBJECTS WITH OCCUPATIONAL CHRONIC OBSTRUCTIVE PULMONARY DISEASE EXPOSED TO INDUSTRIAL AEROSOLS CONTAINING NANOPARTICLES

2021 ◽  
Author(s):  
L.A. Shpagina ◽  
◽  
E.B. Logashenko ◽  
E.V. Anikina ◽  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Silica Nanoparticles ◽  
Pulmonary Disease ◽  
Mass Concentration ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Lung Volumes ◽  
Obstructive Pulmonary Disease ◽  
Occupational Copd

Abstract: Despite decrease in industrial aerosol impact on workers’ health there are disproportionately high prevalence of occupational lung diseases. So, it is of interest to investigate the role of nanoparticles. Objective was to establish lung function features in subjects with occupational chronic obstructive pulmonary disease (COPD) exposed to aerosols containing nanoparticles. Methods. It was a cross-sectional observational study. Subjects with occupational COPD (GOLD 2011-2021 criteria) exposed to aerosols containing metal (n=26) or silica nanoparticles (n=24) enrolled. Comparison group – tobacco smokers with COPD (n=50). Nanoparticles at workplaces air were measured by inductively coupled plasma atomic emission spectrometry and by scanning electron microscopy. Groups were matched by gender, age, COPD duration. Results. Occupational COPD in conditions of metal nanoparticles exposure was characterized by severe airflow limitation – forced expiratory volume in one second (FEV1) was 38%(35%;42%), by prominent increase in lung volumes – functional residual capacity (FRC) was 192% (184%;203%) and by highest decrease in diffusing lung capacity for carbon monoxide (DLco/Va), 34% (31%;38%). In occupational COPD subjects exposed to silica nanoparticles mild airflow limitation, mild increase in lung volumes and substantial decrease in DLco/Va, were seen. In logistic regression model metal nanoparticles mass concentration was associated with DLco/Va, FRC, FEV1, Raw and silica nanoparticles mass concentration – with DLco and FEV1. Conclusion. Nanoparticles in industrial aerosols are associated with occupational COPD phenotype.

Role of Capnograghy during weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ramy Karem Ali Ali ◽  
Yasser Mosafa Mohammed Mostafa ◽  
Tamer Mohammed Ali
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Pulmonary Disease ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Weaning From Mechanical Ventilation ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Chronic Inflammatory Response

Abstract Background Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation associated with an enhanced chronic inflammatory response in the airway, acute exacerbations of COPD can lead to progressive respiratory failure necessitating mechanical ventilation. Weaning of these patients may prove difficult and a spontaneous breath trial should be provided before the decision of extubation. Aim To evaluate the role of capnograghy in COPD patients during weaning from mechanical ventilation. Subject and methods This was a cross sectional prospective study conducted on 50 patients who were admitted at the Respiratory Intensive Care Unit of Abbassia Chest hospital and diagnosed as COPD and on mechanical ventilation. During the weaning trial, the role of capnography device evaluated considering the ability of Pet CO2 parameter in predicting hypercapnia and subsequently weaning outcome Results The changes in ABG reading before and after the SBT, PaCO2 and Pet CO2 showed significant elevation at the end of SBT,P=0.001 for both, while O2 saturation was significantly decrease at the end of SBT, P0.001. Conclusion The study found that Pa CO2 and PetCO2 are correlated to each other before, during and after SBT. Most of the studies that was found reported that PetCO2 is highly correlated with Paco2 and that PetCO2 may be a rapid and reliable predictor of arterial PaCO2 in respiratory distress.

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