Title 32. CHRONIC OBSTRUCTIVE AIRWAY DISEASE.pdf ✅

PHARMD GURU Page 1 DEFINITIONS: The National Heart, Lung, and Blood Institute/World Health Organization (NHLBI/ WHO) Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition of COPD is “a disease state 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 American Thoracic Society definition is similar: A disease state characterized by the presence of airflow limitation owing to chronic bronchitis or emphysema; the airflow obstruction is generally progressive, may be accompanied by airway hyperreactivity, and may be partially reversible. The two major forms of COPD—chronic bronchitis and emphysema—frequently coexist. COPD also coexists with asthma. These guidelines have been updated annually. 1. Chronic bronchitis is characterized by excessive mucus production by the tracheobronchial tree, which results in airway obstruction as a result of edema and bronchial inflammation. Bronchitis is considered chronic when the patient has a cough producing more than 30 mL of sputum in 24 hrs for at least 3 months of the year for 2 consecutive years and other causes of chronic cough have been excluded. 2. Emphysema is marked by permanent alveolar enlargement distal to the terminal bronchioles and destructive changes of the alveolar walls. There is a lack of uniformity in airspace enlargement, resulting in loss of alveolar surface area. The collapse of these small airways results in airflow limitation that is independent of exertion. EPIDEMIOLOGY: Approximately 17 million Americans have COPD. COPD is the third leading cause of death in the United States and the leading cause of hospitalization in the older population. It is most commonly diagnosed in older men; however, the incidence is increasing in women owing to an increasing population of women smokers. Women may be more likely to have more rapidly progressive COPD than men. Asthma is a common comorbidity. CHRONIC OBSTRUCTIVE AIRWAY DISEASE