مرض الانسداد الرئوي المزمن المستقبل

1. Chronic Obstructive Pulmona
ry Disease (COPD)
Prepared by
Dr. Rashad Al.nomani

2. COPD
Defenition
 Chronic disease Characterized by presence
of airflow obstruction
 Caused by emphysema or chronic bronchiti
s

3. Emphysema
Defenition
 Abnormal permanent enlargement of the ai
r space distal to the terminal bronchioles
 Accompanied by destruction of bronchioles

4. Chronic Bronchitis
Defenition
 Presence of chronic productive cough for
3 or more months in each of 2 successive yea
rs in a patient whom other causes of chronic
cough have been excluded

5. COPD
Causes
 Cigarette smoking
 Primary cause of COPD***
 Clinically significant airway obstruction d
evelops in 15% of smokers
 80% to 90% of COPD deaths are related
to tobacco smoking
 > 1 in 5 deaths is result of cigarette smoki
ng

6. COPD
Causes
 Infection
 Major contributing factor to the aggravation an
d progression of COPD
Air pollution

7. Emphysema
Clinical Manifestations
 Dyspnea (most common)
 Progresses in severity
 Patient will first complain of dyspnea o
n exertion and progress to interfering
with dialy activity and rest

8. Emphysema
Clinical Manifestations
 cough with small amounts of sputum
 Patient is underweight (despite adequate
calorie intake)


9. Chronic Bronchitis
Clinical Manifestations
 Earliest symptoms:
 Frequent, productive cough during win
ter
 Frequent respiratory infections

10. Chronic Bronchitis
Clinical Manifestations
 Cough
 Dyspnea on exertion
 Normal weight or heavy
 Ruddy (bluish-red) appearance d/t
 polycythemia (increased Hgb d/t chronic hypoxemia))
 cyanosis

11. Complications
 Pulmonary hypertension (pulmonary vessel co
nstriction d/t alveolar hypoxia & acidosis)
 Cor pulmonale (Rt heart hypertrophy + RV fai
lure)
 Pneumonia
 Acute Respiratory Failure
 Pneumothorax
 Polycythemia

12. Diagnostic Studies
 History and physical Examination

 Chest x-rays(tear drop heart, flat diaphrag
m, hypertransluscens)



13. Diagnostic Studies
 ABGs
  PaO2
  PaCO2 (especially in chronic bronchitis)
  pH (especially in chronic bronchitis)
  Bicarbonate level found in late stages C
OPD

14. management
 Smoking cessation
 Most significant factor in slowing the pro
gression of the disease

15. Drug Therapy
 Bronchodilators – as maintenance therapy
Salmoterol, formeterol, salbutamol,

16. Oxygen Therapy
 O2 therapy
 Raises PO2 in inspired air
 Treats hypoxemia
 Titrate to lowest effective dose

17. The End...
Thanks