Respiratory disorders chronic obstructive pulmonary disease

Respiratory disorders (chronic obstructive pulmonary disease, sleep-related asthma, interstitial lung disease)... 

There are numerous naturally occurring diseases of the respiratory system that may affect either the upper or lower respiratory tract. The models for some of the major respiratory disorders (chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), asthma, fibrotic lung disease) will be briefly summarized. 

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. 

Respiratory Disorders. Topically applied P-blockers can induce asthma or dyspnea in patients with preexisting chronic obstructive pulmonary disease. Clinicians should inquire about a history of pulmonary disorders before initiating glaucoma treatment with P-blockers. A history of restrictive airway disease also contraindicates the use of opioids for treatment of ocular pain. 

Chronic obstructive pulmonary disease is a respiratory condition characterized by irreversible airway obstruction caused by chronic bronchitis or emphysema. The major symptoms of COPD include chronic cough, increased sputum production, and dyspnea. The vast majority of patients with COPD are those who are current or former heavy smokers. Other risk factors for the development of COPD include occupational exposure (dusts, chemicals) and rare genetic disorders (a -antitrypsin deficiency). The medical management of COPD includes pharmacotherapy (bronchodilators, corticosteroids, and antibiotics) in combination with interventions to reduce risk factors for disease progression (e.g., smoking cessation). Some patients require long-term administration of supplemental oxygen. 

Lower respiratory disorders are conditions that obstruct or restrict tracheobronchial tubes, preventing exchange of gases. These conditions are called chronic obstructive pulmonary disease (COPD), and include bronchitis, chronic bronchitis, bronchiectasis, emphysema, asthma, and chronic asthma. 

This mixed disorder often occurs in patients with chronic obstructive pulmonary disease and chronic respiratory acidosis who are treated with salt restriction, dinretics, and possibly glncocorticoids. When diuretics are initiated, the plasma bicarbonate may increase because of increased renal bicarbonate generation and reabsorption, providing mechanisms for both generating and maintaining metabolic alkalosis. The elevated pH diminishes respiratory drive and may therefore worsen the respiratory acidosis. 

Pre-Employment Examination In addition to the standard preemployment examination protocol, special attention should be given to the cardiopulmonary system. Work at high altitudes places greater demands on the circulatory and respiratory systems. For example, medical conditions such as early chronic obstructive pulmonary disease and asthma are more disabling at altitude. Workers with blood disorders (such as sickle ceU anemia, anemia, or polycythemia) wiU find working at high altitudes much more difficult. Medical professionals should be consulted to establish the appropriate medical protocols for the preemployment examinations. 

More broadly, timolol therapy should be considered with caution in patients with any significant sign, symptom, or history for which systemic beta-blockade would be medically imwise.This includes disorders of cardiovascular or respiratory origin (e g., asthma, chronic bronchitis, and emphysema) as well as many other conditions. Spirometric evaluation after institution of timolol therapy may help to identify patients in whom bronchospasm develops after commencement of therapy. In general, however, patients with asthma and other obstructive pulmonary diseases should avoid this drug. Sympathetic stimulation may be essential to support the circulation in individuals with diminished myocardial contractility, and its inhibition by P-adrenoceptor antagonists may precipitate more severe cardiac feilure. 

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