Chronic Obstructive Pulmonary

Decrements in vigilance (i.e., ability to detect small changes in one s environment that occur at unpredictable times) decreased exercise performance in both healthy persons and those with chronic obstructive pulmonary disease... 

Chronic obstructive pulmonary disease (COPD) affects over 5% of the adult population, is the fourth leading cause of death worldwide and is the only major cause of mortality that is increasing worldwide. It is an inflammatory disorder of the lungs, caused mainly, but not exclusively, by cigarette smoking. 15-20% of smokers develop COPD. 

Chronic Obstructive Pulmonary Disease. Table 1 Pathological changes in chronic obstructive pulmonary... 

Chronic Obstructive Pulmonary Disease. Figure 1 Pharmacotherapy of chronic obstructive pulmonary disease (COPD). 

Sin DD, Man SEP (2006) Pharmacotherapy for mortality reduction in chronic obstructive pulmonary disease. Proc Am Thorac Soc 3 624-629... 

Cell BR, Cote CG, Marin JM et al (2004) The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. New Engl J Med 350 1005-1012... 

COPD, chronic obstructive pulmonary disease EAE, experimental autoimmune encephalomyelitis RSV, respiratory syncytial virus SLE, systemic lupus erythematosus. 

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. 

Jubran A, Gross N, Ramsdell J, et al. Comparative cost-effectiveness analysis of theophylline and ipratropium bromide in chronic obstructive pulmonary disease. A three-center study. Chest 1993 103 678-84. 

Tabak, C. et al.. Chronic obstructive pulmonary disease and intake of catechins, flavonols, and flavones the MORGEN Study, Am. J. Respir. Crit. Care Med., 164, 61, 2001. 

Con A Concanavalin A COPD Chronic obstructive pulmonary disease COS Fibroblast-like kidney cell line established from simian cells CoVF Cobra venom CP Creatine phosphate Cp Caeruloplasmin c.p.m. Counts per minute CPJ Cartilage/pannus junction Cr The chemical symbol fir chromium CR Complement receptor CRl, CR2 CR4 Complement receptor types 1, 2 and 4 CR3-a Complement receptor type 3-[Pg.281]

Blockers are contraindicated in patients with severe bradycardia (heart rate less than 50 beats per minute) or AV conduction defects in the absence of a pacemaker. (3-Blockers should be used with particular caution in combination with other agents that depress AV conduction (e.g., digoxin, verapamil, and diltiazem) because of increased risk for bradycardia and heart block. Relative contraindications include asthma, bronchospastic disease, severe depression, and peripheral vascular disease. (3,-Selective blockers are preferred in patients with asthma or chronic obstructive pulmonary... 

Mitral stenosis or regurgitation Mitral valve prolapse Chronic obstructive pulmonary disease Pulmonary embolism Idiopathic ("lone" atrial fibrillation) Thoracic surgery ... 

Monitor for adverse effects of 3-blockers—heart rate, blood pressure, fatigue, masking of symptoms of hypoglycemia and/or glucose intolerance (in patients with diabetes), wheezing or shortness of breath (in patients with asthma or chronic obstructive pulmonary disease), etc. 

Adapted from GOLD Science Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Updated 2005. Available at www.goldcopd.com. Used with permission. 

TABLE 12-2. Treatment Algorithm for Stable Chronic Obstructive Pulmonary Disease... 

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