Respirology Search
Respirology Respirology
chronic%20obstructive%20pulmonary%20disease
CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Chronic obstructive pulmonary disease (COPD) is an inflammatory respiratory disease characterized by reversible airflow limitation.

The patient usually have chronic cough, sputum production or dyspnea with or without history of risk factors for the disease.

The chronic airflow limitation is caused by a combination of small airways disease and parenchymal destruction.

It is a preventable & treatable disease.

Introduction

  • Chronic Obstructive Pulmonary Disease (COPD) should be suspected in any patient who has chronic cough, sputum production or dyspnea with or without history of risk factors for the disease

Definition

  • A preventable & treatable disease with overall severity contributed by exacerbations & comorbidities
  • The persistent airflow limitation is usually progressive & associated with an enhanced chronic inflammatory response in the airways & the lung to noxious particles or gases
  • The chronic airflow limitation is caused by a mixture of small airways disease & parenchymal destruction

Signs and Symptoms

A diagnosis of COPD should be considered in patients over 40 years of age who have a suggestive medical history (ie presence of risk factors) & who present with any of the following:

  • Chronic cough (present intermittently or daily) & sputum production of ≥3 months in each of 2 consecutive years
    • Does not reflect the major impact of airflow limitation on the morbidity & mortality in patients with COPD
    • Cough may be unproductive
  • Exertional breathlessness, wheezing, pursed-lip breathing, dyspnea with or without wheezing
  • Rhonchi, prolonged expiratory phase of respiration, chest hyperinflation, use of accessory muscles for respiration, decreased breath sounds
  • Signs of cor pulmonale: neck vein distention, increased pulmonic component of 2nd heart sound, lower extremity edema, hepatomegaly
  • The absence of wheezing or chest tightness does not rule out a diagnosis of COPD

Risk Factors

Host Factors

  • Hereditary deficiency of alpha-1 antitrypsin
  • Airway hyper-responsiveness
    • Includes asthma
    • May also develop after exposure to tobacco smoke or other environmental insults
  • Lung growth & development
    • Individuals may have reduced maximal attained lung function due to processes during gestation & childhood
  • Infections
    • Reduced lung function can be associated with a history of severe childhood respiratory infections
    • Previous tuberculosis

Exposures

  • Tobacco smoke
    • Most commonly encountered risk factor
    • Includes history of tobacco use or prolonged exposure to second-hand smoke
    • Smoking during pregnancy can put the fetus at risk
  • Occupational dusts & chemicals
  • Air pollution
  • Smoke from home cooking & heating fuels
  • Socioeconomic status
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Managing COPD in primary care
22 May 2017
Chronic obstructive pulmonary disease (COPD) is currently the 10th commonest cause of death in Singapore, with a disease burden of 5.9 percent according to a 2015 population-based survey (EPIC-Asia survey) in Singapore. Pearl Toh spoke with Dr Augustine Tee, chief and senior consultant of the Department of Respiratory and Critical Care Medicine at Changi General Hospital (CGH) in Singapore, on how COPD is often underdetected in the primary care population as symptoms are not specific and diagnosis requires a combination of clinical risk factors, symptoms and spirometry testing.
Original New Drug Application Approvals by US FDA (1- 15 August 2017)
15 Aug 2017
New drug applications approved by US FDA as of 1 - 15 August 2017 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
Efficacy of dual bronchodilators therapy and inhaler devices for COPD management - can ANORO® help your COPD patients?
04 Aug 2017
Chronic obstructive pulmonary disease (COPD) is the fourth cause of global mortality, with experts predicting a potential future rise in the prevalence rates of COPD. 
An update on the pharmacological treatment of asthma
11 May 2016

In conjunction with World Asthma Day which falls on 3rd May 2016, MIMS Doctor speaks to a renowned respiratory medicine specialist, Dato' Dr. Hj Abdul Razak Abdul Muttalif, regarding the chronic airway disease.