The managerment of breathlessness in patients with COPD - Essay Example

The crux of treatment of COPD is management of breathlessness which will be elaborated in this assignment. COPD is defined as "a disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema" (Sharma, 2006). Clinically, chronic bronchitis is defined as the presence of chronic cough with no other etiology and which is productive for at least 3 months during each of the two consecutive years. Emphysema is damage of the air spaces distal to the terminal bronchioles, the damage being irreversible, abnormal and associated with destruction of the air space walls with no obvious fibrosis (Fromer and Cooper, 2008).

The global prevalence of COPD is about 7.5% of which 6.4% is due to chronic bronchitis and only 1.8% due to emphysema (Sharma, 2006). In adults above 40 years of age, the prevalence is estimated to be about 9-10% (Sharma, 2006). Men are most commonly affected by this disease. However, the incidence in women is increasing due to increased smoking (Sharma, 2006). COPD is associated with certain mortality and morbidity. The mortality rates in the world vary quite a lot and can be anywhere between 100- 400 deaths per 100,000 males (Sharma, 2006).

The most common cause of COPD is cigarette smoking (Silvermann and Speizer, 1996). This condition affects about 15% of cigarette smokers (NICE, 2004). Other risk factors for the development of COPD are air pollution especially due to solid cooking fuels, presence of airway hyperresponsiveness (Sharma, 2006). The characteristic pathophysiological changes in COPD are seen in the central airways, the peripheral airways and also the lung parenchyma. Diverse mechanisms are implicated in the pathophysiology of COPD (Thurlbeck, 1990).

Primary offenders like oxidative stress due to free radicals from cigarette smoke and oxidants from phagocytes and polymorphonuclear leukocytes trigger the release of