Medication use in chronic lung disease
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medicine use for chronic lung disease. for pulmonary rehabilitation program
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Medication use in chronic lung disease
- 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
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- 9. 9 Short Acting Bronchodilators (SABA & SAMA)
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- 14. 14 1 puff bd
- 15. 15 1-2 puff bd
- 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)
- 20. 20 250mg/day or 500mg 3x/week AntibioticsAntibiotics There are no data showing the efficacy or safety of azithromycin treatment to prevent COPD exacerbations beyond one year of treatment.
- 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
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- 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
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Editor's Notes
- 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.