2. Introduction
Medication use in chronic lung disease
a) Bronchodilator
Beta2 agonists,
Anti muscarinics
Methylxanthines
Combination bronchodilator therapy
b) Antiinflammatory agents
Inhaled corticosteroids (ICS)
Oral glucocorticoids
PDE-4 Inhibitors
Antibiotics
Mucolytics/antioxidants
Other anti-inflammatory agents
2
3. Chronic lung disease is a term used for a number of
disease that attack the lungs for the long term. This
disease prevents air flow from inside the lungs so that
people will have difficulty in breathing1
.
3
16. Have numerous side effects, including steroid
myopathy which can contribute to muscle weakness,
decreased functionality and respiratory failure in
patients with severe COPD.
It plays a role in the acute management of
exacerbations.
They have no role in the chronic daily treatment in
COPD because of a lack of benefit against a high
rate of systemic complications. 16
17. Theophylline works as an anti-inflammatory
drug and relaxes the muscles in the airways.
Theophylline comes as a pill.
17
18. 18
o Beneficial effect : greater in patients with
a prior history of hospitalization for an
acute exacerbation. Currently, no study
directly comparing roflumilast with an
inhaled corticosteroid.
o Adverse effect : nausea, reduced
appetite, weight loss, abdominal pain,
diarrhoea, sleep disturbance &
headache.
(Phosphodiesterase-4 (PDE4) inhibitors)(Phosphodiesterase-4 (PDE4) inhibitors)
21. In COPD patients not receiving inhaled
corticosteroids, regular treatment with mucolytics
e.g Carbosysteine and N-acetylcysteine may
reduce exacerbations and modestly improve
health status.
21
22. Alpha-1 antitrypsin augmentation therapy
◦ Intravenous augmentation therapy may slow down the
progression of emphysema
Antitussives
◦ There is no conclusive evidence
of a beneficial role of antitussives in patients with COPD.
Vasodilators
◦ Vasodilator do not improve outcomes and may worsen
oxygenation. E.g Sildenafil does not improve the results
of rehabilitation in patients with COPD and moderately
increases pulmonary artery pressure.
23. Influenza vaccine
- Can reduce serious illness and death in COPD
patients.
Pneumococcal vaccine
-PCV 13 & PPSV23, are recommended for all
patients > 65y.o.
-PPSV 23 is also recommended for younger COPD
patients with significant co morbid conditions
including chronic heart or lung disease.
23
30. 1. MH Themes, (2018). Chronic Lung Disease Definition in Medical,
WordPress at http://diseasedetail.com/chronic-lung-disease-definition/
accessed on 3rd
May 2018.
2. GOLD GUIDELINE 2018, Pocket Guide to COPD Diagnosis, Management
& Prevention , A Guide for Health Cafe Professionals 2018 Report
3. Ashraf El Adawy (2017). Optimising treatment for COPD. Accessed
https://www.slideshare.net/ashrafeladawy/optimising-treatment-for-copd on
3rd May 2018.
30
Chronic Lung Disease is generally a combination of two respiratory diseases, namely chronic bronchitis and emphysema.
Bronchitis is an infection of the air passages leading to the lungs causing swelling of the bronchial walls and the production of fluid in the airways excessively. While emphysema is the condition of the destruction of air sacs in the lungs that occur gradually. The airbag will bubble and deflate as we draw and exhale. Flexibility of the air sac will decrease if a person has emphysema, consequently the amount of air coming in will decrease.
Chronic obstructive pulmonary disease (COPD) is
a disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases2.
COPD should be considered in any patient who has dyspnea, chronic cough production, and/or a history of exposure to risk factors for the disease.
Treatment aims to relieve symptoms and inhibit the progression of the disease1.
Pharmacologic therapy can reduce COPD symptoms, reduce the frequency and severity of exacerbations, and improve health status and exercise tolerance2.
However, several medications can help reduce inflammation and open the airways to help patient breathe easier with COPD.
It is often caused by tobacco smoking, but in some cases it’s caused by breathing in toxins from the environment. Host factors include
genetic abnormalities, abnormal lung development and accelerated aging may predispose individuals to develop chronic lung disease2
For some people with severe COPD, the typical first-line treatments, such as fast-acting bronchodilators and corticosteroids, don’t seem to help when used on their own. When this happens, some doctors prescribe a drug called Theophylline along with a bronchodilator.