Stable Stage of Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease is a common respiratory disorder characterized by early-stage damage primarily focused on the small airways and lung parenchyma. The disease can be prevented and treated.

What is stable chronic obstructive pulmonary disease (COPD)?

Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by inflammation of the bronchial mucosa that leads to slowly progressive and irreversible airflow limitation. The inflammatory response is linked to exposure to harmful dust particles or gases, with cigarette and tobacco smoke being the leading cause of the disease (accounting for up to 90% of cases).

COPD is a chronic lung disease that commonly causes initial damage to the small airways and lung tissue. The disease can be prevented and treated.

Risk factors for COPD

Men over 40 years old.

Individuals with a history of smoking.

Environmental air pollution in the living area.

Occupations that expose to a lot of dust such as foundry workers, metallurgical workers, construction workers, etc.

Genetic factors.

Symptoms of COPD

Persistent coughing for a long time is the first symptom in people with COPD. Patients may cough continuously or intermittently. The duration of coughing should be at least 3 months per year. Dry cough or cough with sputum, especially in the morning.

The condition of difficulty breathing becomes more and more serious over time. Initially, patients only experience shortness of breath when exerting themselves, but gradually, even when resting, they still feel breathless.

Coughing with phlegm and shortness of breath usually appear when the disease is in the severe stage.

Diagnosis of COPD

Definitive diagnosis

For patients in the high-risk group and those with suspected COPD symptoms, the following tests need to be performed to make a definitive diagnosis:

Measurement of lung function using a spirometer:

This is considered the gold standard for diagnosing and evaluating the severity of the disease.

This is the gold standard for making a definitive diagnosis and evaluating the severity of COPD.

The Gaensler index (FEV1/FVC) <70%; FEV1 does not increase or increases by less than 12%.

The severity of the patient’s obstruction can be assessed based on FEV1.

Chest X-ray can rule out other lung diseases that have similar clinical manifestations such as lung cancer, bronchiectasis, and pulmonary fibrosis. Additionally, chest X-ray can detect accompanying conditions such as pleural effusion, pneumothorax, and heart failure.

Electrocardiogram (ECG)

In advanced stages, signs of pulmonary hypertension and right heart failure may be observed.

Differential diagnosis

COPD needs to be differentiated from other conditions such as:

• Tuberculosis
• Bronchiectasis
• Bronchial asthma
• Overlap syndrome

Treatments for Chronic Obstructive Pulmonary Disease (COPD)

 General treatments

Smokers should seek smoking cessation methods.

Avoid risk factors such as cigarette smoke, charcoal smoke, gas fumes, dust, etc.

Receive respiratory infection vaccines if available.

Patients with COPD who are over 65 years old, have FEV1 below 40%, or have cardiovascular, liver, or kidney diseases should receive pneumococcal vaccination once every 5 years.

Administer flu vaccination during the fall for COPD patients.

Restore respiratory function for the patient.

Other measures that should be taken include: regular nasal and throat hygiene, keeping the neck area warm in cold weather, and early treatment of respiratory infections.

 Use of Medications

 Beneficial

• Cholinergic antagonists (short-term benefit)
• β 2 agonists (short-term benefit)
• Combination of cholinergic antagonists and β 2 agonists (more effective than monotherapy)
• Short-term oral steroids

May be beneficial

Long-term oxygen therapy

Trade-off between benefit and harm:

• Theophyllines.
• Mucolytics.

Effectiveness uncertain

• Inhaled corticosteroids
• Maintenance treatment with oral corticosteroids
• Antibiotics.