Internal illnesses. Chronic obstructive pulmonary diseases (COPD) (lecture notes)

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Internal illnesses. Chronic obstructive pulmonary diseases (COPD) (lecture notes)

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LECTURE No. 28. Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease is a heterogeneous group of pulmonary diseases that are combined by a disorder of the function of external respiration of the lungs according to the obstructive type.

They are diagnosed at late stages, when progression becomes inevitable, despite the use of modern treatment programs.

COPD includes chronic diseases of the respiratory system: chronic obstructive bronchitis (88-90%), severe bronchial asthma (8-10%), emphysema (1%).

In the US and UK, the COPD group also includes cystic fibrosis, bronchitis obliterans, and bronchiectasis. With generalized obstruction, differential diagnosis is carried out.

Pathogenesis, clinic, diagnosis and treatment of individual nosological forms of COPD are described independently.

Rehabilitation. For COPD of any severity, a sparing regimen, exercise therapy, physiotherapy, spa treatment are prescribed). Therapy of cardiovascular pathology is shown: angiotensin-converting enzyme inhibitors, calcium channel blockers, diuretics, antiplatelet agents, digoxin (in severe forms of COPD, cor pulmonale).

Management in an outpatient setting.

Early detection of patients is necessary (for mild and moderate course of the disease), early appointment of adequate basic therapy (for mild COPD, 3-week therapy with atrovent is necessary with the possible connection of mucolytics, further prescription of bronchodilators according to indications (weather conditions, nature of work, bad habits), with COPD of moderate and severe course requires a long-term (permanent) intake of bronchodilators (atrovent, berodual 2 doses 3-4 times a day), if necessary, saltos, teopec, teodur, etc. are added, with mucostasis - mucolytics; taking bronchodilators can be discontinued with stabilization of the subjective state and stable stabilization of peak expiratory flow rates for 3 months). Patients are being monitored after ARVI or influenza with a long-lasting cough, unproductive, spastic in nature, not stopped by taking antitussive drugs (appointment of Atrovent for 3 weeks).

Author: Myshkina A.A.

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