Chronic obstructive pulmonary disease acute exacerbation

Community-acquired pneumonia, acute bacterial exacerbations of chronic obstructive pulmonary disease, acute bronchitis due to Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae. 

Fatal Aspergillus myocarditis, probably related to shortterm administration of glucocorticoids, has been described in a 58-year-old man, who had an acute exacerbation of his chronic obstructive pulmonary disease and received oxygen, bronchodilators, omeprazole, co-amoxiclav, and intravenous methylprednisolone 40 mg 8-hourly he died 5 days later and postmortem examination showed a fungal myocarditis (337). 

Acute Exacerbations of Chronic Obstructive Pulmonary Disease, edited by N. M. Siafakas, N. R. Anthonisen, and D. Georgopoulos... 

A 69-year-old man developed acute benzodiazepine withdrawal delirium following a short course of flunitrazepam after an acute exacerbation of chronic obstructive pulmonary disease. He was not an alcohol-or drug-abuser and he had not previously taken benzodiazepines. Six days after withdrawal of flunitrazepam he became agitated and confused, and had visual hallucinations, disorganized thinking, insomnia, increased psychomotor activity, disorientation in time and place, and memory impairment. Tachycardia and significant anxiety were also noted. He fulfilled the DSM IV criteria for withdrawal syndrome and delirium, and had spontaneous remission of symptoms within 48 hours. 

Dales RE. Granulocyte inflammatory markers and airway infection during acute exacerbation of chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2001 163 349-355. 33. 

Nebulizers are generally used to treat acute exacerbations of asthma or chronic obstructive pulmonary disease. Other indications include long-term bronchodilator treatment of chronic airflow obstruction prophylactic treatment for asthma antimicrobial drugs for cystic fibrosis, bronchiectasis, and HIV/AIDS and symptomatic relief in palliative care. 

Collet J-P, Shapiro S, Ernst P, Renzi P, Ducruet T, Robinson A, P-ISSCaR Group Effects of an Immunostimulating agent on acute exacerbations and hospitalizations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1997 156 1719-1724. 

Bach PB, Brown C, Gelfand SE, McCrory DC. Management of acute exacerbations of chronic obstructive pulmonary disease A summary and appraisal of published evidence. Ann Intern Med 2001 134 600-620. 

Russo RL, D Aprile MD. Role of antimicrobial therapy in acute exacerbations of chronic obstructive pulmonary disease. Ann Pharmacother 2001 35 576-581. 

Azithromycin, an azalide macrolide antibiotic (500 mg p.o. as a single dose on day 1, followed by 250 mg daily on days 2 to 5 total accumulation dose is 1.5 g), is indicated in the treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease caused by Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, or Streptococcus pneumoniae mild community-acquired pneumonia caused by H. influenzae or S. pneumoniae uncomplicated skin and skin-structure infections caused by Staphylococcus aureus, Streptococcus pyogenes, or S. agalactiae second-line therapy of pharyngitis or tonsillitis caused by S. pyogenes and in nongonococcal urethritis or cervicitis caused by Chlamydia trachomatis. 

Cazzola, M., Caputi, M Santangelo, G., Diu Vinciguerra, A., Pema, F. D., and Polverino, M. (1997). A five-day course of dirithromycin in the treatment of acute exacerbation of severe chronic obstructive pulmonary disease. J. Chemother. 9, 279-284. 

Aaron SD, Angel JB, Lunau M, Wright K, Fex C, Le Saux N, Dales RE. Granulocyte inflammatory markers and airway infection during acute exacerbation of chronic obstructive pulmonary disease. Am J Respir Ciit Care Med 2001 163 349—355. Seemungal TA, Harper-Owen R, Bhowmik A, Jeffries DJ, Wedzicha JA. Detection of rhinovirus in induced sputum at exacerbation of chronic obstructive pulmonary disease. Eur Respir J 2000 16 677-683. 

The two most prevalent chronic inflammatory lung diseases are asthma and chronic obstructive pulmonary disease (COPD). These diseases are a major and increasing global health problem. Both asthma and COPD share some clinical features, such as increased airway obstruction, mucous hypersecretion, acute exacerbations and respiratory symptoms. Asthma and COPD are identified by the presence of chronic inflammation of the airways, which is controlled by the increased expression of inflammatory proteins, including cytokines, chemokines, receptors, enzymes and... 

Fujimoto, K. et al. (2005) Airway infiammation during stable and acutely exacerbated chronic obstructive pulmonary disease. The European Respiratory Journal, 25, 640-646. 

Sint, T, Donohue, J.E, Ghio, A.J., 2008. Ambient air pollution particles and the acute exacerbation of chronic obstructive pulmonary disease. Inhalation Toxicology 20 (1), 25-29. 

One case report of SIADH was noted on day 2 of treatment with moxifloxacin for an acute exacerbation of chronic obstructive pulmonary disease (COPD). SIADH has many causes, some of which were potentially present in this patient however, careful monitoring for adverse events is recommended in all [62 ]. 

Pulmonary Two patients experienced serious adverse drug reactions. The first was an acute exacerbation of chronic obstructive pulmonary disease with dyspnoea in a patient who smoked and was diagnosed with ocular hypertension and chronic obstructive pulmonary disease. This was deemed probably related to study treatment. The episode resolved about 14 days after oral prednisolone treatment was initiated. Bimatoprost 0.01% was discontinued and the patient was switched to brinzolamide 1%. The second serious adverse drug reaction was an asthma attack in a patient with bilateral glaucoma and asthma. This was deemed possibly related to study treatment. The patient recovered about 2 weeks after discontinuation of bimatoprost 0.01% [37]. 

Abbreviations. MV, mechanical ventilation AECOPD, acute exacerbation of chronic obstructive pulmonary disease ALD, acute lung disease ALI, acute lung injury ARDS, acute respiratory distress syndrome CLD, chronic lung disease COPD, chronic obstructive pulmonary disease MOF, multiple organ failure NMD, neuromuscular disease NR, not reported. 

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