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PULMONOLOGY
GOLD treatment update
In patients
who smoke,
smoking cessation
is very important.
Pharmacotherapy and nicotine
replacement reliably increase
long-term smoking abstinence rates.
Appropriate pharmacologic therapy
can reduce COPD symptoms, reduce the
frequency and severity of exacerbations,
and improve health status and
exercise tolerance.
To date, none of the
existing medications
for COPD has been shown
conclusively to modify
the long-term decline in lung
function. Each pharmacological
treatment regimen needs to be
patient-specific, guided by severity
of symptoms, risk of exacerbations,
drug availability, and the
patient’s response.
Treatment
recommendations
All patients who get short of
breath when walking on their
own pace on level ground should
be offered rehabilitation. It can
improve symptoms, quality
of life, and physical and
emotional participation
in everyday activities.
Non-surgical bronchoscopic
lung volume reduction
techniques should not be used
outside clinical trials.
Influenza and pneumococcal
vaccination should be offered to
every COPD patient. They appear
to be more effective in older
patients and those with
more severe disease or
cardiac comorbidity.
C
OPD is the fourth leading cause of
death in the world. The main culprits
are inhaled cigarette smoke and
exposure to other noxious particles
such as smoke from biomass fuels that cause
lung inflammation.
According to the authors of the guideline,
this chronic inflammatory response may induce
parenchymal tissue destruction, resulting in
emphysema. This disrupts the normal repair
and defence mechanisms, causing small airway
fibrosis. These pathological changes lead to air
trapping and progressive air flow limitation, and
in turn to breathlessness and other characteristic
symptoms of COPD.
Symptoms
Chronic and progressive dyspnoea, cough, sputum
production that can be variable from day-to-day,
The Specialist Forum | Vol. 17 No. 4
The Global Initiative
for Chronic
Obstructive Lung
Disease (GOLD)
recently updated
their treatment
guideline for
chronic obstructive
pulmonary
disease (COPD).
In this article, we
will focus on a
brief overview of
COPD, treatment
options and drug
recommendations.
dyspnoea (increased effort to breathe, heaviness,
air hunger, or gasping), chronic cough as well
as wheezing and chest tightness (according to
the authors) an absence of wheezing or chest
tightness does not exclude a diagnosis of COPD,
nor does the presence of these symptoms
confirm a diagnosis of asthma). Fatigue, weight
loss and anorexia are common problems in
patients with severe and very severe COPD.
Pharmacological options
Pharmacologic therapy for COPD is used to
reduce symptoms, reduce the frequency and
severity of exacerbations, and improve health
status and exercise tolerance. The choice within
each class depends on the availability and cost
of medication and the patient’s response.
The classes of medications commonly used in
treating COPD are:
May 2017
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