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34 Cards in this Set
- Front
- Back
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COPD aka...
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COLD
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GOLD
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Global initiative for Chronic Obstructive Lung Disease
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Organizations that formed GOLD
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1998 US national heart, lung, and blood institute and WHO
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Gold Global strategy
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Diagnosis
Management Treatment Prevention |
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Kacmarek COPD Def.
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Longterm persistent airway obstruction of the intrathoracic airways manifested by
-dec. exp. flow rates -airflow obstruction associated with airway hyperactivity (constriction) -airflow obstruction maybe partially reversible (bronchodialators) |
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During exp intrathoracic airways....
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narrow
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Why does air trapping occur?
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premature closing of small airways
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GOLD Def. COPD
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Preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual pts
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COPD's pulmonary component is characterized by...
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airflow limitation that is not fully reversible
-limitations are usually prograssive -associated with an abnormal inflammatory response of the lung to noxious particles or gases |
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The chronic airflow limitation is caused by a mixture of...
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small airway disease in the form of obstructive bronchiolitis
parenchymal (alv) destruction in the form of emphysema |
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Airflow Limitations are caused by...
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Small airways disease
Parenchymal destruction |
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COPD prevalence, morbidity, and mortality are directed related to
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-smoking
-air pollution -indoor air pollution --burning of wood --other biomass fuels |
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Morbidity
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Ruin quality of life
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Death caused by COPD has been increasing steadily since...
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1970
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4th leading cause of death is
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COPD
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Risk Factors for COPD are caused by which particles
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Tobacco Smoke
Occupational dust, organic and inorganic Indoor pollution from heating and cooking with biomass in poorly ventilated dwellings Outdoor air pollution |
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Other Risk Factors for COPD
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Genes
Exposure to particles Lung growth and development Oxidative stress Gender Age Repetitive Resp. Infections (chronic inflammation) Socioeconomic status Nutrition Comorbidities (CHF, Renal Disease) |
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Causes of COPD
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Smoking
Pollution Passive Smoking (2nd Hand) Occupational Exposure to dusts and fumes Infection Heredity Allergies Socioeconomic Status Alcohol ingestion Aging |
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Smoking
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Highest Correlation with COPD of all risk factors
-short or long term exposure -responses vary among individuals |
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Burning cigarettes produces
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Tar
Nicotine (addictive part) Over 2000 known compounds -Carbon Monoxide -Nitrogen Oxide -Amonia -Hydrogen Cyanide -Nitrosamines |
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Nicotine
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Highly toxic alkaloid
Readily absorbed thru mucosa Stimulates sympathetic and parasympathetic |
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Sympathetic and Parasympathetic Stimulation from nicotine
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Increased HR
Increased Myocardial Contractility Increased VR Increased mobilization of fatty acids |
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Effects of cigarette smoke on the lung
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Inhibits ciliary function
Causes bronchospasm Affects macrophage activity Causes disruption of alv. septal wall and capillary endothelium Cough Expectoration Decreased pulm. function tests |
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The amt of harmful substances recieved depends on...
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Filtered vs unfiltered
Behavioral factors -# of cigs per day -depth of inhaltion -breath holding -length of cig butts |
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Pack yrs
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# of packs x # yrs smoked
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Cigs have an adverse effect on incidences of...
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Bronchogenic carcinoma (10x)
Coronary artery disease Cerebral vascular accident Peripheral vascular disease Peptic ulcer disease Allergy Hematologic disorders |
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Adverse effects of cigs on pregnancy
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Prematurity
Low birth weight |
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Air pollutant causes of COPD
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Outdoor
-particulate and gaseous pollution Indoor -Heating and cooking with wood of biomass fuels on poorly ventilated dwelling |
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Passive smoking - COPD
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Same toxic substances, lower concentrations
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Occupational causes of COPD
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Exposure to dusts and fumes
-dusts -chemicals -fumes |
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Infection - COPD
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Exposure to infection causes
-decreased pulm. clearance -increased incidence of recurrent infection -recurrent inflammation and damage |
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Heredity - COPD
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Alpha 1 Antitrypsin Deficiency
-Genetic -Emphysema changes occur in the lung -meaureable in the 30's and 40's Serum protein made in the liver. When it gets to the lungs it will neutralize elastase so that it will not break down the elastin fibers |
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ZZ
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patients without alpha 1 antitrypsin
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Aralast
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meds to stop elastase from destroying elastin fibers
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