Compare & Contrast COPD / Asthma Worksheet (Chapter 24; CDC site; Videos) What is COPD? Chronic Obstructive Pulmonary disease: preventable and treatable slowly progressive respiratory disease of airflow obstruction involving the airways, pulmonary parenchyma, or both Pathophysiology: Usually manifests during middle adult years, with prevalence increasing with age. Progressive airflow limitation leads to the lungs abnormal response to gasses. This induces inflammation which the body is trying to counteract causing narrowing and thickening of the airway walls. The elastic recoil in alveoli decreases and contribute to airflow limitation. Risk Factors: Environmental exposures/cigarette smoking/occupational dust and chemicals/indoor air pollution/genetic abnormalities Clinical Manifestations: Three classic symptoms: Classic cough, sputum production and dyspnea. Weight loss can occur, respiratory insufficiency and COPD exacerbation/barrel chest Diagnostic Tests: Spirometry to evaluate airflow obstruction. Arterial blood gas measurements to assess baseline oxygenation and gas exchange. High res CT to help in differential diagnosis. Screening for alpha 1 antitrypsin deficiency (if under 45) Complications: Respiratory insufficiency/respiratory failure. How is Smoking Related to COPD? There is a connection between decline in pulmonary function and intensity of cigarette smoking. Smoking depresses the activity of scavenger cells and the respiratory tracts ability to clean itself properly. The malfunction of the cleaning mechanism causes airflow obstruction. There is also an accumulation of mucus which increases infection and irritation. How Can COPD Be Prevented? Reducing risk primarily associated with smoking and secondhand smoke How is COPD Treated: Pharmacologic Treatment: corticosteroids and bronchodilator medications/supplemental oxygen therapy Patient Education: Promoting smoking cessation/smoking cessation program/Nutritional counseling to promote weight loss and adequate nutritional needs being met/Coping measures to deal with anxiety and depression or changes in behavior r/t health state. What is Asthma? an abnormal airway condition characterized primarily by reversible inflammation Pathophysiology: Factor causes inflammation;the body responds in a hyper manner which leads to airflow limitation; produces symptoms of wheezing and coughing and chest tightness. Diffuse airway inflammation leads to airway narrowing. Risk Factors: Respiratory infection/air pollution/active and passive smoking/Atopy/being female gender/exposure to indoor and outdoor allergens/weather changes/foods/stress/exercise/hormonal factors/GI reflux/mold/pet dander/ Clinical Manifestations: Cough/chest tightness/wheezing/dyspnea/sometimes mucus producing cough/effort for air expiration/diaphoresis/tachycardia/engorged neck veins Diagnostic Tests: Sputum and blood tests might disclose elevated levels of eosinophils. Arterial blood gas analysis. Complications: status asthmaticus/respiratory failure/pneumonia/atelectasis/airway obstruction How is Smoking Related to Asthma? The effects of smoke on an asthmatic person is the same response that happens during an asthma flare up which include irritated and swollen airway filled with sticky mucus. How Can Asthma Attacks Be Prevented? Reducing risk factors can be helpful and also identifying and avoiding triggers if possible. How is Asthma Treated? Pharmacologic Treatment: medications to minimize bronchoconstriction and airway inflammation. Fluids given for dehydration as needed for hyperventilation and diaphoresis. Immunomodulators/oxygen supplementation as needed/antileukotrienes/in severe cases bronchial thermoplasty Patient Education: Peak flow monitoring/education on proper use of inhaler or nebulizer/refer to community support groups/regular health screenings/nutritional intake/when to call for help/learning about triggers and avoidance if possible.
