Bronchitis obstruction

A. Classification and Prototypes The major air pollutants in industrialized eountries inelude carbon monoxide (whieh aeeounts for about 50% of the total amount of air pollutants), sulfur oxides (18%), hydrocarbons (12%), particulate matter (eg, smoke particles, 10%), and nitrogen oxides (6%). Ambient air pollution appears to be a contributing factor in bronchitis, obstructive pulmonary disease, and lung cancer. 

Other disorders of the lower respiratory tract include emphysema (lung disorder in which the terminal bronchioles or alveoli become enlarged and plugged with mucus) and chronic bronchitis (chronic inflammation and possibly infection of die bronchi). Chronic obstructive pulmonary disease (COPD) is die name given collectively to emphysema and chronic bronchitis because die obstruction to die airflow is present most of the time. Asdima diat is persistent and present for most of die time may also be referred to as COPD. 

Sympathomimetics (drugs that mimic the sympathetic nervous system) are used primarily to treat reversible airway obstruction caused by bronchospasm associated with acute and chronic bronchial asthma, exercise-induced bronchospasm, bronchitis, emphysema, bronchiectasis (abnormal condition of the bronchial tree), or other obstructive pulmonary diseases. 

Chirila, M., Negut, E., Herold, A., Chirila, P. and Szegli, G. (1987). The epurox therapy in allergic bronchitic asthma and chronic obstructive bronchitis - clinical insights. Arch. Roum. Path. Exp. Microbiol. 46, 267-275. 

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. The most common conditions comprising COPD are chronic bronchitis and emphysema. 

The most common cause of acute respiratory failure in COPD is acute exacerbation of bronchitis with an increase in sputum volume and viscosity. This serves to worsen obstruction and further impair alveolar ventilation, resulting in worsening hypoxemia and hypercapnia. Additional causes are pneumonia, pulmonary embolism, left ventricular failure, pneumothorax, and CNS depressants. 

Chronic Obstructive Lung Disease (COLD) and Cor pulmonale COLD is known to be an outcome of chronic air pollution exposure. Although tobacco smoke is known to be the major risk factor, studies in India and Nepal have found that non-smoking women who regularly cook on biomass stoves exhibit a higher prevalence of COLD than would be expected, or which appears in women who use them less frequently. Indeed, due to indoor exposure, nearly 15% of non-smoking women in Nepal (20 years and older) had chronic bronchitis a very high rate for nonsmokers (ESCAP, 1995). 

Fishwick, D., Bradshaw, L. M., D Souza, W., Town, I., Armstrong, R., Pearce, N., and Crane, J. (1997b). Chronic bronchitis, shortness of breath, and airway obstruction by occupation in New Zealand. Am. J. Respir. Crit. Care Med. 156,1440-1446. 

The TP receptor requires the G/G protein to activate the Src-Ras-ERKl/2 (extracellular signal-regulated kinase 1 and 2) cascade to induce the proliferative response, which in turn promotes the rapid nuclear translocation of activated ERKl/2 (201). Because TP receptor may be activated by many inflammatory mediators (202-204), these findings suggest new therapeutic strategies that alter the ASM hypertrophy or hyperplasia observed in the chronic airflow obstruction and airway inflammation that characterizes asthma, chronic bronchitis, bronchiolitis obliterans, and chronic obstructive pulmonary disease. 

Bronchodilation can be achieved by the use of ipratropium in conditions of increased airway resistance (chronic obstructive bronchitis, bronchial asthma). When administered by inhalation, this quaternary compound has Uttle effect on other organs because of its low rate of systemic absorption. 

Particulate matter air pollution is especially harmful to people with lung disease such as asthma and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, as well as people with heart disease. Exposure to particulate air pollution can trigger asthma attacks and cause wheezing, coughing, and respiratory irritation in individuals with sensitive airways. It was estimated in one major study that the excess risk of total mortality is 6.2% per each increase in 10pgPM2.s/m and 9.3% for cardiopulmonary mortality. ... 

Theophylline reduces contractile activity of smooth musculature, widens bronchi and blood vessels, reduces pulmonary vascular resistance, stimulates the respiratory center, and increases the frequency and power of cardiac contractions. It is used for bronchial asthma, preventing attacks, and systematic treatment. Theophylline is also used for symptomatic treatment of bronchospastic syndrome of a different etiology (chronic obstructive pulmonary disease, chronic bronchitis, and pulmonary emphysema). A large number of combined drags are based on theophylline. Synonyms of theophylline are adophyllin, asthmophyllin, theocin, and many others. 

MicroNefrin Chronic obstructive lung disease, chronic bronchitis, bronchiolitis, bronchial asthma, and other peripheral airway diseases croup (postintubation and infectious). 

Injection - To relieve respiratory distress in bronchial asthma or during acute asthma attacks and for reversible bronchospasm in patients with chronic bronchitis, emphysema, and other obstructive pulmonary diseases severe acute anaphylactic reactions, including anaphylactic shock and cardiac arrest to restore cardiac rhythm. 

Chronic obstructive pulmonary disease (COPD)- For long-term, twice daily (morning and evening) administration in the maintenance of bronchoconstriction in patients with COPD including chronic bronchitis and emphysema. 

Mucolytic Adjuvant therapy for abnormal, viscid, or inspissated mucus secretions in chronic bronchopulmonary disease (chronic emphysema, emphysema with bronchitis, chronic asthmatic bronchitis, tuberculosis, bronchiectasis, primary amyloidosis of lung) acute bronchopulmonary disease (pneumonia, bronchitis, tracheobronchitis) pulmonary complications of cystic fibrosis tracheostomy care pulmonary complications associated with surgery use during anesthesia posttraumatic chest conditions atelectasis due to mucus obstruction diagnostic bronchial studies (bronchograms, bronchospirometry, bronchial wedge catheterization). 

Chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis For the twice-daily maintenance treatment of airflow obstruction in patients with COPD associated with chronic bronchitis. Fluticasone propionate/salmeterol 250 meg per 50 meg twice daily is the only approved dosage for the treatment of COPD associated with chronic bronchitis. Fligher doses, including fluticasone propionate/salmeterol 500 meg per 50 meg, are not recommended. 

Pulmonary disease Pilocarpine has been reported to increase airway resistance, bronchial smooth muscle tone, and bronchial secretions. Administer with caution and under close medical supervision in patients with controlled asthma, chronic bronchitis, or chronic obstructive pulmonary disease. 

One should consider infiuenza- and pneumococcal-vaccination in patients with increased risk for lower RTI including patients with chronic obstructive pulmonary disease like chronic bronchitis or emphysema and cystic fibrosis patients. It should be considered for the elderly population in general. There is no role for prophylactic antibiotic therapy in patients with frequent RTI. Attempts should be made to have those patients that smoke stop doing so. 

The American Thoracic Society (ATS) defined COPD as a disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema the airflow obstruction is generally progressive, may be accompanied by airway hyperreactivity, and may be partially reversible. 

Chronic bronchitis was defined as the presence of chronic productive cough for 3 months in each of two successive years in a patient in whom other causes of chronic cough have been excluded. Emphysema was defined as abnormal permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis. The Global initiative for Chronic Obstructive Lung Disease (American Thoracic Society/European Respiratory Society... 

Decramer M, Rutten-van MoUcen M, Dekhuijzen PN, Troosters T, van Herwaarden C, Pellegrino R et al. Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis randomized on NAC cost-utility smdy, BRONCUS) a randomised placebo-controUed trial. Lancet 2005 365(9470) 1552-60. Erratum Lancet 2005 366(9490) 984. Comment Lancet 2005 365(9470) 1518-20. 

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