Introduction
Chronic obstructive pulmonary disease or COPD is an adverse condition that is characterized by dyspnea often accompanied by cough and sputum production. The condition usually develops due to continuous exposure to inflammatory stimuli. As such, the disease is most often seen in smokers. Besides cigarette smoke, stimuli may include heavy particles contained in polluted air, dust, or gas. COPD exists in two main forms such as emphysema and chronic bronchitis. The symptoms described above result from obstruction of airways with mucous, which results in higher CO2 levels in the lungs. Chronic bronchitis is usually accompanied by cough with sputum production.
The diagnosis of chronic bronchitis requires the application of GOLD criteria. According to GOLD, chronic bronchitis is diagnosed after pulmonary function testing (PFT) shows an FEV1/FVC ratio of 0.70 (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). The airflow limitation is categorized into four stages of severity by the percentage of predicted air inflow. The stages are as follows: more than 80%, less than 80%, less than 50%, and less than 30%. For preliminary assessment, perdition of the disease, and the need for PFT one can use pack-years of cigarette smoking.
Medication Therapy
Chronic Bronchitis is usually treated with short-acting beta-agonists (SABAs). Severe and moderate cases may require long-acting beta-agonists (LABAs) (Ejiofor & Turner, 2013). Popular generic SABA is Albuterol sulfate or ipratropium bromide. LABAS are available in the U.S. under the generic name fluticasone or salmeterol packed with an inhalation device. Inhaled corticosteroids (ICSs) can also be effective against the symptoms of bronchitis at the third or fourth stage but long-term use may result in the development of pneumonia. Popular ICS are budesonide and fluticasone. One of the best solutions is to use LABAS in conjunction with ICS. Combination therapy is widely used in the U.S. Mostly, doctors prescribe salmeterol and fluticasone. These two components are reported to produce the synergic effect (Ejiofor & Turner, 2013). Additionally, continuous oxygen therapy can be a solution that can both increase the lifespan and reduce the symptoms of bronchitis and other COPD. 15 hours of oxygen inhalation is considered a norm for Long-term oxygen therapy (Ejiofor & Turner, 2013).
Behavioral Interventions
The primary reason for the emergence and development of the condition is the behavior that includes regular cigarette smoking or the inhalation of the byproducts of smoking. Therefore, it is paramount to alternate such behavior in a patient in order to prevent the disease from progressing or happening in the first place. Early education in patients can be considered as an intervention to prevent the formation of smoking behavior. The demonstration of the damage smoking does to health could prove invaluable in controlling COPD in all patients. For active smokers quitting smoking is the best intervention that could prevent the disease from progressing. Quitting attempts can and be accompanied by nicotine replacement therapy. In case when it is not an option, it is recommended to refrain from actions or people that communicate the desire to smoke. Support groups and/or encouragement from family, friends, and coworkers could also be beneficial in this endeavor. Secondhand smoke is also deadly and directly related to the emergence of COPD. Avoidance can be fostered by visiting only smoke-free zones and locations.
Conclusion
All things considered, chronic bronchitis and other COPD are adverse conditions that decrease the quality of life and can lead to death in severe cases. It could be managed with pharmacotherapy such as SABAs, LABAs, ICSs, and the combinations of them. The primary intervention to prevent or stop COPD from progressing is quitting smoking and avoiding inhaling secondhand smoke.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins
Ejiofor, S., & Turner, A. M. (2013). Pharmacotherapies for COPD. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, 7, 17–34.