COPD Flashcards
Give three disease processes of COPD
Airway inflammation
Mucus hypersecretion
Tissue damage
Explain the disease process in COPD
Cigarette smoke
Alveolar macrophage production
Release of neutrophil chemotactic factors, cytokines (IL-8), mediators (LTB4), oxygen radicals between macrophages and neutrophils
Neutrophils produce proteases
Causes alveolar wall destruction (emphysema) and mucus hypersecretion (chronic bronchitis)
Give the clinical aspects of COPD
Chronic symptoms (not episodic) Smoking Non-apotic Daily productive cough Progressive breathlessness Frequent infective exacerbations Chronic bronchitis - wheezing Emphysema - reduced breath sounds
What are the elements of the chronic cascade in COPD?
Progressive fixed airflow obstruction Impaired alveolar gas exchange Respiratory failure Pulmonary hypertension Right ventricular hypertrophy/failure Death
What non-pharmacological treatment can be given for COPD?
Smoking cessation Physical activity Stent Venesection Lung volume reduction surgery Oxygen - domiciliary Immunisation
What pharmacological treatment could be given for COPD?
SAMA/LAMA - ipratropium/tiotropium SABA/LABA - salbutamol/salmeterol LAMA/LABA combination LABA-ICS combination PDE4I - Roflumilast Mucolytic - carbocisteine Antibiotics
Name the cells that secrete the main component of mucus
Goblet cells
Give 2 types of emphysema
Centriacinar and Panacinar
As emphysema advances what does the increase in PaO2 cause?
Dyspnoea and increased respiratory rate Pulmonary vasoconstriction (and pulmonary hypertension)
In what rare genetic condition are there high rates of emphysema?
a (alpha) 1 antitrypsin deficiency
What enzymes produced by neutrophils and macrophages is elastic tissue in the lung sensitive to?
Elastases
Give 4 affects of tobacco smoke on the body
Increases the number of neutrophils and macrophages in the lung
Slows the transit of these cells
Promotes neutrophil degranulation
Inhibits a (alpha) 1 antitrypsin
