COPD Case Studies

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COPD 2 INTRODUCTION COPD, chronic obstructive pulmonary disease is an overall term for the conditions of chronic bronchitis and emphysema. It is noted that bronchodilator therapy is necessary in managing the symptoms; also, reducing exacerbations improving the quality of life. Primary care generally diagnoses and manages COPD. COPD is a progressive condition where air flow becomes limited which makes it difficult to breathe. This is the third leading cause of death in the United States. Studies have been made to expand surveillance to evaluate the effectiveness of prevention and intervention programs and support efforts for educating the public and physicians about COPD symptoms, diagnoses, and treatment. Information…show more content…
These are important factors in relief and management of symptoms. The long-acting beta2 agonists (LABAs) include salmetrol and formoterol. They last 12 hours in duration, and indacaterol lasts 24 hours with once-daily dosing. These drugs are primarily to relax the airway smooth muscles by stimulating the beta2 adrenergic receptors, and providing functional antagonism to bronchoconstriction. The resulting Broncho dilation increases the function capacity of the lung, reduces the symptoms of breathlessness, lessens restrictions on the patient’s ability to undertake everyday activities, increases exercise capacity and reduces exacerbations (Kaufman, G., 2013, p. 35). The long-acting muscarinic antagonist (LAMA) tiotropium is a once-daily therapy for COPD; lasting at least 24 hours. It is associated with significant and sustained Broncho dilation, improvements in lung function, improved exercise endurance and fewer exacerbations from COPD. It is important that short and long-acting muscarinic antagonists are not prescribed together because ipratropium and tiotropium block the same subtype of muscarinic receptors in airway smooth muscle and the effect of ipratropium on one of the receptor subtypes can minimize the effect of tiotropium and can also increase side effects (Kaufman, G., 2013, p.…show more content…
The system dose of most drugs administered by inhalation is reduced compared to therapies given orally or intravenously. Delivering therapy directly to the lungs also allows more rapid Broncho dilation. The aims of inhaled therapy are to achieve optimal control of the disease by limiting exacerbations, improving lung function, limiting symptoms and improving quality of life. Additionally, most COPD occurs in older adults who may have comorbidities (pert. to a disease that exists simultaneously with and worsens or affects a primary disease) such as impaired eyesight, tremor, arthritis, and cognitive problems that can aggravate effective use of the inhaler device. Inhaler devices available to deliver inhaled medications are COPD 6 Pressurized metered-dose inhalers (pMDIs); Breath-activated pMDIs; Dry-powder inhalers (DPIs); and Soft mist inhaler (SMIs) (Kaufman, G., 2013, p. 37). The nurses in primary care have an important role in helping patients with this disease. That is where device selection and patient education comes in. Primary care nurses should know the following: * For the prescribed drug/s what devices are available and what number of device types can be used? * Which inhaler device is the patient likely to use successfully? * How can I ensure that the patient will be taught correct inhaler

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