Obstructive lung diseases

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has defined COPD as a disease state characterized by airflow limitation that is not fully... 

GOLD Global Initiative for Chronic Obstructive Lung Disease... 

COLD Chronic obstructive lung disease EEG Electroencephalogram... 

Respiratory acidosis Acidosis caused by retention of carbon dioxide due to a respiratory abnormality (e.g., chronic obstructive lung disease). 

A 60 year-old male with chronic obstructive lung disease is given ipratropium as part of his therapeutic regimen. What is the mechanism of action of ipratropium ... 

Infection of the trachea and bronchi causes hyperemic and edematous mucous membranes and an increase in bronchial secretions. Destruction of respiratory epithelium can range from mild to extensive and may affect bronchial mucociliary function. In addition, the increase in bronchial secretions, which can become thick and tenacious, further impairs mucociliary activity. Recurrent acute respiratory infections may be associated with increased airway hyperreactivity and possibly the pathogenesis of chronic obstructive lung disease. 

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). 

Anxiety is common among the elderly but the literature regarding the assessment, diagnosis, and treatment of these illnesses in older individuals is sparse (Blazer 1997). Most often anxiety does not present for the first time in late life. If that is the case one should suspect an underlying condition or other external cause. These causes could be medications such as digitalis, antipsychotics but also conditions as anaemia, chronic obstructive lung disease with hypoxia or myocardial infarction. 

Centers for Disease Control and Prevention (CDC) (2002). Fixed obstructive lung disease in workers at a microwave popcorn factory—Missouri, 2000-2002. MMWR. Morb. Mortal. Wkly. Rep. 51,345-347. 

Centers for Disease Control and Prevention (CDC) (2007b). "Hazard Evaluation and Technical Assistance Report Report on Severe Fixed Obstructive Lung Disease in Workers at a Flavoring Plant." US Department of Health and Human Services, CDC, National Institute... 

Santa Cruz. R., J. F. Landa, I. Hirsch, and M. A. Sackner. Tracheal mucous velocity in normal man and patients with obstructive lung disease effects of terbutaline. Amer. Rev. Respir. Dis. 109 458-463, 1974. 

Obstructive lung disease, as measured by pulmonary function tests, has been associated with wood dust exposure. Vermont woodworkers with hardwood or pine dust exposures greater than lOmg-years/m generally had lower pulmonary function, as determined by FEVi/FVC, than those with exposure indices of 0-2 mg-years/m. Higher exposures also significantly lowered values of the maximal midexpiratory flow rate (MMEFR), compared with theoretical values. 

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

Chronic exposure can result in obstructive lung disease, emphysema, and kidney disease. Cadmium may also be related to increases in blood pressure (hypertension) and is a possible lung carcinogen. Cadmium affects calcium metabolism and can result in bone loss. This condition has been referred to as Itai-Itai disease, which means Ouch-Ouch in Japanese and reflects the bone pain associated with cadmium effects on calcium. 

Theophylline, a dimethylxanthine, causes broncho-dilation, possibly by inhibiting the enzyme phosphodiesterase in smooth muscle of the bronchioli. An other proposed mechanism of action is that of adenosine receptor antagonism. It has positive chronotropic and inotropic, CNS stimulant and weak diuretic properties. In obstructive lung disease sustained release tablets are to be preferred. Theophy-line has a narrow therapeutic index. Therapeutic plasma concentrations are between 7-15 mg/1. Theophylline undergoes N-demethylation via CYPl A2 in the liver and is eliminated in the urine as metabolites... 

Risk factors in the host can give a clue for the causative pathogen e.g. Chronic Obstructive Lung Disease (COPD) - Haemophilus, alcoholism - Klebsiella, HIV - Pneumocystis. The immunocompromised host is also at increased risk for certain fungal (Aspergillus) and viral infections (cytomegalovirus or CMV). Pseudomonas aeruginosa is frequently involved in exacerbations of cystic tibrosis. 

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... 

ISOLDE Inhaled Steroids in Chronic Obstructive Lung Disease in Europe EUROSCOP European Respiratory Society Study on Chronic Obstructive Pulmonary Disease BUD = budesonide PRED = prednisolone. 

Zanamivir is contraindicated in individuals with severe or decompensated chronic obstructive lung disease or asthma because it has not been shown to be effective in these individuals and can cause serious adverse pulmonary reactions. Individuals with mild to moderate asthma may have a decline in lung function when taking zanamivir. The safety and efficacy of this medication have not been determined in individuals with severe renal insufficiency. No clinically significant drug interactions have been reported. Zanamivir does not decrease the effectiveness of the influenza vaccine. 

Most adverse effects associated with aerosol ribavirin are local. Pulmonary function may decline if aerosol ribavirin is used in adults with chronic obstructive lung disease or asthma. Deterioration of pulmonary and cardiovascular function has also been seen in severely ill infants given this preparation. Rash, conjunctivitis, and rare cases of anemia have been reported. Health care workers exposed to aerosol ribavirin during its adminis-... 

Respiratory system (chronic obstructive pulmonary disease [COPD emphysema, chronic bronchitis], acute obstructive lung disease [asthma], chronic restrictive lung disease [connective tissue lung disease])... 

In the lungs, NO affects not only blood vessels but also the bronchi and bronchioles as well. In newborns with defective gas exchange, NO inhalation decreases pulmonary arterial blood pressure, enabling more blood to be oxygenated. In adults with obstructive lung diseases, NO inhalation seems to relax airway smooth muscle, thus acting as a bronchodilator. 

Seixas, N. S.. Robins, T. G., Attfield, M. D. Moulton, L. K 1992. Exposure-response relationships for coal-mine dust and obstructive lung-disease following enactment of the Federal Coal-Mine Health and Safety Act of 1969. American Journal of Industrial Medicine, 21, 715-734. 

Buist S for the Executive Committee, Global Initiative for Chronic Obstructive Lung Disease Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease Medical Communications Resources, Inc. 2007. http //www.goldcopd.com... 

Correct answer = B. o1-Antitrypsin deficiency is a genetic disorder that can cause pulmonary emphysema even in the absence of cigarette use. An deficiency of a1-antitrypsin permits increased elastase activity to destroy elastin in the alveolar walls, even in nonsmokers. a1-antitrypsin deficiency should be suspected when chronic obstructive pulmonary disease develops in a patient younger than 45 years who does not have a history of chronic bronchitis or tobacco use, or when multiple family members develop obstructive lung disease at an early age. 

Osteoporosis induced by chronic glucocorticoid therapy has been reviewed in patients with obstructive lung diseases (195) and patients with skin diseases (196). 

Goldstein MF, Fallon JJ Jr, Haming R. Chronic glucocorticoid therapy-induced osteoporosis in patients with obstructive lung disease. Chest 1999 116(6) l 733—49. Yosipovitch G, Hoon TS, Leok GC. Suggested rationale for prevention and treatment of glucocorticoid-induced bone loss in dermatologic patients. Arch Dermatol 2001 137(4) 477-81. 

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