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Chronic Obstructive Pulmonary Disease pptx

This presentation provides an overview of COPD,it's causes and risk factors, pathophysiology, clinical signs and symptoms, diagnosis,complication, manegement.

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Respiratory System•
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INTRODUCTION:  COPD Stands for ‘CHRONIC OBSTRUCTIVE PULMONARY DISEASE’.  It refers a group of lungs disease that cause obstruction in the airflow from the lungs and inflammation in the air sacs[ALVEOLI].  It is progressive and irreversible disease.
TYPES OF COPD 1.Emphysema: Emphysema is a long – term progressive lung disease where the air sacs in the lungs become damaged, and leading to difficulty in breathing.  This damage cause the air sacs to lose their elasticity making it harder for them to expand and contract property. 2.Chronic Bronchitis: It is defined as long term inflammation of bronchial tubes. Cough is mainly caused by oversecretion of mucus. People with bronchitis breath less air and O2 into the lungs.
FACTORS COUSING COPD:  Smoking  Air Pollution  Occupational dust  Genetics  Respiratory infections
PROCESS OF OCCURING COPD 1.CHRONIC BRONCHITIS  Mucus hypersecretion  Sub mucosal: hypertrophy, hyperplasia  Thickening of bronchial walls/inflammation  COPD 2. EMPHYSEMA  Engulfment by macrophages/phagocytosi  Cytokines release  Neutrophils activation  Protease release  Alveolar wall damage  COPD
SIGN & SYMPTOMS:
TREATMENT 1. SELFCARE:  Quit Smoking  Exercise Regulatory  Avoid dust, cold air, pollution  Stay Hydrated  Eat Healthy
2. OXYGEN THERAPY:  O2 therapy for COPD gives you extra O2 to you to breathe easier.  Its usually give through a mask or small tubes in your nose.  This extra O2 helps your body get the O2 it needs when your lungs are not working well.
3. MEDICATION TREATMENT: [A] BRONCHODILATORS:  Bronchodilators are the medications that relax and open the airway to help breathing easier.  These drugs relax the smooth muscle of the airway allowing for improved airflow.  TYPES: 1. B2 Agonist: Salbutamol, Terbutaline 2. Anticholinergics: Ipratropium, Tiotropium 3. Methylxanthine: Theophylline, Aminophylline, Doxophylline.
1.BETA 2 AGONIST:  MOA: These are beta 2 adrenergic receptor on airway smooth muscles.  Activation of these receptors stimulates adenylate cyclase, raising cAMP level in smooth muscle cells.  Lower Ca2+ level relax the airway smooth muscle. SALBUTAMOL  It is a short acting beta2 adrenergic receptor agonist used for the relief of bronchospasm in condition such as COPD.  MOA: It stimulates the beta2 receptor leads to rise in cAMP level causing smooth muscle relaxation.
FORMOTEROL  Formoterol is a potent, rapid-onset, and long-acting beta2 adrenergic receptor agonist used as bronchodilator to treat COPD.  It work within 2-3 minutes and last over 12 hours.  MOA: Formoterol binds with high affinity to bera2 adrenoceptors on the bronchial smooth muscle cells.  Stimulation of these receptor activates the enzyme adenylate cyclase.  Increasing cAMP level leads to bronchodilation.
2.ANTI-CHOLINERGIC AGENTS:  MOA: Anticholinergic agents block muscarinic receptor inn lungs.  This reduces bronchoconstriction by inhibiting acetylcholine action.  Leads to relaxed airway and improved airway flow in asthma.  IPRATROPIUM BROMIDE  It is an anticholinergic agent which is chemically related to atropin.  MOA: It blocks muscarinic cholinergic receptors, resulting in a decrease in the formation of cGMP.  This results in decreased contractility of smooth muscle.
3.METHYLXANTHINE:  MOA: They inhibits phosphodiesterase enzyme, increasing cAMP level.  Elevated cAMP levels reduces airway smooth muscle, leading to bronchodilation.  THEOPHYLLINE  Theophylline, known as dimethylxanthine drug used in COPD.  MOA: It causes bronchodilation by inhibiting phosphodiesterase, leading to increased cAMP level and relaxation of bronchial smooth muscle.
[B] ANTI-INFLAMMATORY AGENTS :  Anti- Inflammatory medications in COPD reduce swelling and irritation in the airway to help improve breathing.  TYPES: 1. CORTICOSTEROIDS 2. LEUKOTRIENE MODIFIER 3. PDE4 [PHOSPHODISTEREASES] INHIBITORS
1. CORTICOSTEROIDS:  In COPD, they are used as like pills and inhalers.  Pills wax faster, and help during flare-ups.  Pharmacokinetics: 1. Absorption: Corticosteroids are absorbed through the lungs, digestive system or skin , depending on the form. 2. Distribution: The circulate in the bloodstream and reach target tissues, including the lungs. 3. Metabolism: They are broken down mainly in the liver. 4. Excretion : Metabolite's are excreted mainly through urine.
MODE OF ACTION:  They block substance that causing inflammation in airway  Decrease activity of immune cells that increase inflammation  Reduce mucus production  Improve airflow  Therapeutic Uses: Inflammation, COPD  Adverse Effects: Osteoporosis, Hypertension, Diabetes  Example: Hydrocortisone, Prednisolone, Fluticasone
BUDESONIDE  It is used in COPD and asthma to reduce airway inflammation.  It prevents sypmtoms like- wheezing, breathlessness.  It is not for immediate relief having long – term control.  MOA: Budesonide enters airway cells and binds to glucocorticoid receptors.  This activates anti- inflammatory proteins and blocks inflammatory genes.  Result in decrease inflammation, cytokines production.
2.LUEKOTRIENE MODIFIER:  Leukotriene modifier are medications that blocks chemical called leukotrienes, which cause inflammation and narrowing of the airway  They are used to prevent mild to moderate asthma and can bean alternative to inhaled steroids.  EXAMPLES: Montelukast, Zafirlukast & Zileuton  Pharmacokinetics: 1. Absorption: They are absorbed through digestive system. 2. Distribution: They are carried in the bloodstream to targrt organs in lungs. 3. Metabolism: Mostly metabolised in liver. 4. Excretion: Excreted mainly through urine and feces.
MODE OF ACTION:  They block leukotriene receptors  Decrease swelling is airways  Relax airway  Decrease mucus production  Improve airflow and easy to breathing  Therapeutic Uses: Asthma, COPD, Allergies  Adverse Effects: Headache, Nausea, Fatigue ,Diarrhoea  Example: Montelukast, Zafirlukast
MONTELUKAST  Montelukast is a leukotriene receptor antagonist used in the management of COPD.  Montelukast is taken orally and helps in long-term control of symptoms, but it is not a first-line drug for COPD.  MOA: It works by blocking the leukotriene receptors, so leukotriene cannot produce their harmful effects.  As a result, airway inflammation is reduced, mucus secretion decrease, and breathing becomes easier.
3.PDE4 [PHOSPHODISTEREASE]INHIBITOR:  They are medications that act by blocking the enzyme called PDE4 and reduce inflammation in the lungs and help to relax the airway, making it easier to breathe, especially in condition like: COPD.  Pharmacokinetics: 1. Absorption: They are absorbed through the digestive system. 2. Distribution: They are distributed in the bloodstream to the lungs and other tissues. 3. Metabolism: Primarily metabolized in the liver. 4. Excretion : Excreted mainly through urine and feces.
MODE OF ACTION:  Blocks PDE4 enzyme, which cause inflammation in lungs  Decrease swelling and irritant in airway  Thus, open airway and reduce mucus prodution  Easy to breathe  Therapeutic Uses: COPD, Chronic Bronchitis  Adverse Effect: Nausea, Diarrhoea  Example: Roflumilast
ROFLUMILAST  It is an oral anti- inflammatory drug used in severe COPD, especially in patients with chronic bronhitis.  It is mainly used to reduce COPD exacerbations, not for immediate relief.  MOA: Roflumilast inhibits PDE4 enzyme, normally PDE4 breaks down cAMP.  Inhibition of PDE4 increases cAMP level leads to reduce inflammatory cell activity.