Chronic Obstructive Pulmonary Disease - a Use of Ipratropium Bromide Inhaler, Lifestyle Changes Patient Needs to Adopt - Case Study Example

Name Course name Name of Institution Instructor’s name Date Contents About COPD 3 Main causes of COPD to Bill 4 COPD treatment 5 Instructions on how to use ipratropium bromide inhaler 6 Lifestyle changes that Bill needs to adopt. 7 Conclusion 8 References 9 About COPD Chronic obstructive pulmonary disease (COPD), is a disease that makes breathing difficult[NIH14]. The disease is progressive which means that it gets worse over time. Its major symptoms are coughing which produces large amounts of mucus, shortness of breath, chest tightness and wheezing like in Bill’s case. It is mainly caused by smoking, and long-exposure to air pollution, dust or chemical fumes. So that Bill can understand COPD he has to understand how the lungs operate. The air that one breaths goes into windpipe, then into tubes in the lungs known as bronchial tubes. In the lungs, these tubes branches into bronchioles which are smaller and thinner. From here the air enters tiny round air sacs called alveoli. Capillaries run through the walls of these sacs. When oxygen reaches the alveoli, it enters into the capillaries through the walls of the alveoli. At the same time, carbon (IV) oxide enters the air sacs from the blood capillaries. When one breathes in, the air sacs gets filled with air and look like small balloons[NIH14]. On the other hand, when one breaths out they deflate. In the case of OCPD, less air flows in and out the airways. This is because of the following; air sacs and the airways lose their elastic nature. COPD destroys the walls of the air sacs. It also makes the walls of the airways thick and inflamed. Moreover, the airways makes more mucus than normal which clogs them. COPD comprises of three conditions. They are emphysema, chronic asthma and chronic bronchitis. In the case of emphysema, air sac walls are destroyed which makes them lose their shape and become floppy. The damage also leads to larger and fewer air sacs instead of the many tiny ones. This reduces the amount gas exchange that takes place in the lungs. On the other hand, in the case of bronchitis, airways lining is in most times irritated and inflamed which causes the lining to thicken. A lot of mucus also forms in the airways which makes them clog thus making breathing difficult[NIH14]. Lastly, chronic asthma is a condition that is characterized by inflammation of the airways. This airways (bronchial tubes) also have increased production of mucus. OCPD is a major cause of disability[Rob13]. It develops slowly and its symptoms get worse over time making it difficult for patients to do their routine activities[NIH14]. In the case of Bill, severe COPD has made it difficult for him to do basic activities such walking to the local club to enjoy a few beers with his friends. His difficulty in breathing has also increased recently. Since he is 69 years old and has worked has a coal miner for 31 years, the condition has slowly been developing inside him without his knowledge. This is because he has constantly been exposed to dust from the mines which has been making him have problems breathing. COPD has no cure and the doctors have not yet come up with a way of reversing damage to the lungs and the air ways. For Bill to slow down the progress of the disease, he has to seek treatments and change his lifestyles. This will help him feel bait better and stay more active. Main causes of COPD to Bill Mainly one is most likely to suffer from COPD because of breathing in particles that irritates their lungs such as smoke, dust or toxic chemicals. Bill has worked as a coal miner for 31 years. Though he is not a smoker which is the leading cause of COPD, he has had prolonged exposure to coal dust[Gra14]. This coal dust has over the years entered his respiratory system and affecting his gas exchanging tissues[CDC12]. Long term exposure to coal dust has caused damages to his air sacs and airways making gas exchange in the lungs difficult. This has led to his problems in breathing. Also, over the years he has been exposed to chemical fumes from the mines. Moreover, working underground for 31 years which is damp environment with low oxygen concentration has also been increasing risk of developing chronic obstructive pulmonary disease. Another cause may be secondhand smoke. Even though Bill does not smoke, he likes enjoying a few beers with his friends at a local bar where other people smoke. Breathing in this smoke increased his chances of developing COPD. Moreover, Bill may have a genetic condition known as alpha-1 antitrypsin deficiency. This is a defect in the DNA which leads to inadequate proteins in the lungs required to protect them from damage. COPD treatment Doctors have not yet found a cure for COPD. However, treatment and change in life style can help Bill feel better, slow down the progress of the disease and also enable him lead an active life again. The main reasons for seeking treatment are includes efforts to relieve his symptoms. Secondly, slow down the progress of the disease. Thirdly, treat and prevent more severe complications. Fourthly, to improve his exercise tolerance that is increasing his ability to stay active. Lastly, to improve his overall health[NIH15]. Bill when he visited a doctor and was diagnosed with chronic obstructive pulmonary disease, he was prescribed ipratropium bromide inhaler BD. He was also prescribed a course of Doxycycline 100mg TDS. Ipratropium bromide inhaler is bronchodilator that enlargers air ways in the lungs. It helps in blocking the effects of acetylcholine on bronchi and nasal passage. Nerves use this chemical (acetylcholine) to communicate with muscle cells. Since Bill has chronic obstructive pulmonary disease, his cholinergic nerves which goes to the lungs stimulates muscles that surround airways to contract. This leads to the narrowing of the airways thus causing breathing difficulties. Using ipratropium bromide which is an anti-cholinergic, reverses the effects of cholinergic nerves by relaxing the muscles and thus enlarging the airways. When ipratropium bromide is inhaled it goes straight to the airways and very little is absorbed by the body[Ogb15]. Other forms of treatment that Bill may seek include antibiotics which help to treat acute exacerbations. Also, he should lung therapies such as supplemental oxygen. This is by use of external devices to help deliver enough oxygen into the lungs[Nav15]. He should ask for doctors’ advice on when to use oxygen therapy. In addition, he should sign up for pulmonary rehabilitation program. In this program, he will be trained on how to exercise, educated on the disease, advised on nutrition and counseled. This program is very important because it will shorten hospitalization, improve his life quality and improve his ability to take part in every day routine. Instructions on how to use ipratropium bromide inhaler Bill should stand up or sit upright. He should also lift his chin to open the airways. He should remove the cap from the mouthpiece of the inhaler and then shake the inhaler. Since he hasn’t used the inhaler before, he should spray it in the air to make sure it works. He then should insert the mouthpiece of the inhaler to the hole at the end of the spacer. After that he should take deep breath at put his teeth around the spacer mouthpiece. To spray one puff of the medicine into the spacer, he should press down the canister in the inhaler. He then should breathe in slowly and hold his breath for at least 10 seconds. After that he should breathe out and then in through the mouthpiece of the spacer and hold his breath. If he requires another dose he should wait for 30 seconds[Mar10]. Lifestyle changes that Bill needs to adopt. To prevent progress of chronic obstructive pulmonary disease, Bill needs to change his current life style. He has to avoid places with dust such as the coal mining site. Also, he has to avoid secondhand smoke because inhaling tobacco smoke will worsen his situation. He also has to avoid place with fumes and toxic substances. He should remain indoors on days when air is dusty. He can monitor this by checking the air quality and its pollution forecast in his locality. This will help him avoid inhaling dusty or polluted air which will worsening his condition[Don13]. Also, he should get a flu vaccine every year and always consult with his doctor to know if he requires a pneumonia vaccine. This is to prevent infections such as cold which if the develop they make COPD condition worse. Bill has recently lost appetite which can be attributed to shortness of breath and fatigue. This has made him lose weight. Loss of appetite makes him not get all the nutrients and calories that his body requires. This can make his condition worse and also lead to other infections. To fight loss of appetite, Bill may be required to change his eating habits and start eating smaller quantities of food frequently[Pri09]. He may also be required to take vitamins and nutritional supplements and rest before eating. He should also start eating more vegetables, fruits, nuts, whole grains, olive oil and fish. On the other hand, he should avoid eating red meat, processed foods and sugar. It is difficult to be active with such symptoms but regular physical exercise helps in strengthening muscles which aid in breathing[Pri09]. Bill should engage in physical activities every day to help strengthen his body. This will help him to be active again and improve his overall health[NIH15]. Bill should also protect himself from respiratory infections such as cold. He can do so by washing his hands with soap before and after a meal. Secondly, by getting vaccinated against influenza every year. Lastly, maintaining oral hygiene that is brushing teeth at least twice a day and visiting his dentist after every six months. Bill appears to be anxious. This is very risky for a person suffering from COPD. In order to avoid succumbing to anxiety, Bill needs to visit a doctor so that he maybe advised on how to deal with his emotional issues and be given medication. He can also join a support group, meditate frequently or adopt a special breathing technique[NIH15]. He should also see a referral psychologist who will assist him with his anxiety and emotional issues. He should also be prepared for emergencies at all times. He can do so by familiarizing himself with new localities that he visits in order to know the places he can go for treatment if he experiences difficulties in breathing. Also, he should keep his doctors number on speed dial and always notify him or her in case of a new symptom. Moreover, he should keep close friends or ensure he is in good terms with family members who can assist him in case of an emergency[NIH15]. If his condition deteriorates, Bill should start attending pulmonary rehab program (PRP) which will help increase physical function. By doing so his breathing will increase making him more health and active. Conclusion Chronic obstructive pulmonary disease is a progressive disease meaning that it gets worse overtime. It affects respiratory organs causing breathing difficulties. Its symptoms are no clear and in most cases people are diagnosed when it is severe. This is because the disease develops slowly. It took Bill 31 years of breathing difficulties before he could know what he was suffering from. People should get educated more on the disease that is its symptoms causes and forms of treatment. By doing so, people will get diagnosed when the disease is in its early stages and seek medical help in time. With good mediation, regular physical exercise and proper diet, a patient of COPD can live a long quality life. References NIH14: , (NIH., 2014), Rob13: , (Roberts J, 2013), Gra14: , (Graber M, 2014), CDC12: , (CDC, 2012), NIH15: , (NIH, 2015), Ogb15: , (Ogbru, 2015), Nav15: , (Navarro, 2015), Mar10: , (Marshall, 2010), Don13: , (Donaldson G C, 2013), Pri09: , (Price D, 2009), Read More