Asthma Vs Copd Treatment
In general, there are two types of lung diseases. These are known as obstructive and restrictive lung diseases. The most common lung diseases that are obstructive in nature are Emphysema, Chronic Bronchitis, and Asthma.
If anyone is diagnosed with Chronic Obstructive Pulmonary Disease, then he or she has at least two of these diseases. And for this reason, every COPD patient is treated differently considering the nature and cause of the disease.
The severity of the disease can be mild, moderate, or severe. And the type or level of treatment generally depends on the severity of the disease.
Pulmonary rehabilitation can be the best treatment plan amongst many other COPD and asthma treatment plans. This includes a planned set of exercises, counseling, and training on disease management.
This will help the patients to accomplish daily tasks with comfort and ease. Also, it helps them to stay active on a regular basis.
Studies show that breathing exercise is a very good treatment plan for COPD as well as asthma. By following a good nutrition chart and a proper breathing exercise program, a patient can live with ease and comfort.
Medication for COPD can be part of the treatment which can be given as steroids, antibiotics, or immunizations depending on the severity of the disease.
Installing a humidifier in rooms is also good and is many times recommended by doctors for relieving the issue.
Is Chronic Asthma The Same As Copd
Chronic asthma and COPD can have similar symptoms, but they are considered distinct conditions. COPD refers specifically to chronic bronchitis, emphysema or both.
Other differences include the fact that asthma tends to start during childhood, while COPD is more likely to appear among adults who smoke.
Symptoms And Signs Of Copd And Asthma
COPD symptoms differ on the basis of disease severity . Most patients with COPD usually first develop a chronic productive cough. However, dyspnea is the hallmark symptom of COPD and usually prompts patients to seek medical care. As disease severity progresses, cough and dyspnea result in decreased exercise tolerance and increased disability. COPD mainly affects the lungs however, notable systemic effects are also associated with COPD. Patients with COPD often experience changes in their metabolism and in caloric intake. Indeed, 50% of patients with severe disease experience weight loss, which is associated with a poorer prognosis.3 Patients with COPD also develop decreased strength, decreased exercise capacity and a reduced quality of life.3 COPD is associated with an increased risk of cardiovascular disease, respiratory infections, osteoporosis and glaucoma.
Physiologic changes associated with asthma include bronchoconstriction, airway hyperresponsiveness and airway inflammation. Therefore, patients with asthma typically develop wheezing, shortness of breath and cough. Because asthma is also characterized by reversible airway obstruction, its symptoms are intermittent and cover a spectrum from mild-to-severe disease.
Several symptoms overlap in patients with COPD and asthma. Nevertheless, a history of wheezing strongly suggests a diagnosis of asthma, whereas chronic cough productive of sputum is more indicative of COPD.
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What Is Severe Asthma
Someone with severe asthma has a specific type of asthma which doesnt get better with the usual medicines.
Even if someone takes those medicines exactly as prescribed, a different approach is needed to control symptoms and reduce frequent asthma attacks.
Other causes and triggers for the symptoms have also been ruled out as much as possible.
Around 4 out of 100 people with asthma have severe asthma, which is about 200,000 people in the UK.
If your GP or asthma nurse suspects you have severe asthma they may refer you to an asthma specialist clinic for an in depth assessment.
Your GP or asthma nurse will continue to look after your asthma while you are waiting to see the specialist team and will continue to share responsibility for your care even when you are seeing them.
We dont understand yet why some people get asthma and some people get severe asthma, says Dr Andy Whittamore, Asthma UK’s in-house GP.
We know that each individual with asthma can have different triggers and a different chemical reaction in their airways.
Thats why Asthma UK is supporting research looking into what goes on in the body to cause severe asthma, and what makes it so much harder to control with the usual asthma medicines.
Prevention Of Copd And Asthma
COPD is a preventable disease. Although primary prevention hinges on tobacco cessation strategies, secondary prevention of COPD centers on early diagnosis, risk factor modification and treatment. However, early diagnosis of COPD is often delayed. In 2002, the third National Health and Nutrition Examination Survey 7 reported that approximately 24 million adults in the USA have evidence of impaired lung function on spirometry however, only about 50% of these patients have physician-diagnosed COPD, most of which is moderately advanced disease. At this late stage of disease, only tertiary prevention, aimed at preventing the complications of COPD, is effective. Therefore, primary and secondary prevention strategies need to be improved.
Better prevention of COPD can be achieved through compliance with guidelines. Numerous guidelines exist to assist physicians in early diagnosis, prevention of disease progression and management of COPD, including those of GOLD, the American Thoracic Society, the National Collaborating Center for Chronic Conditions and the Canadian Thoracic Society.
Numerous guidelines are also available to aid physicians and other healthcare professionals to better prevent and manage asthma. Two frequently referenced guidelines are those of the NAEPP and the Global Initiative for Asthma .
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Airway Remodelling And The Overlap Syndrome
There is also increased airway wall remodelling in the overlap syndrome, with increased bronchial wall thickening on high resolution CT . Increased thickness of the airway wall is an important feature leading to airway obstruction in most airway diseases. In asthma, this is due to inflammation, subepithelial fibrosis and increased thickness of the smooth muscle. There is also increased thickness of the airway wall in COPD, which is not as prominent as in asthma, but involves the same structures of the epithelium, reticular basement membrane, airway smooth muscle and mucous glands. There is also evidence of remodelling, fibrosis and inflammation in these structures. The increased smooth muscle reported in COPD is seen in some but not all studies. Increased thickness of the airway epithelium and goblet cell hyperplasia are features of the remodelled airway in both asthma and COPD. Similarly, increased airway wall fibrosis is reported in both asthma and COPD. Thus when considering the pathological changes within the airways that are associated with asthma and COPD, there is similarity in terms of structures that are remodelled, but differences in the degree of changes in specific structures.
Basis And Quality Of Data
Irritant-induced obstructive airways diseases cannot usually be diagnosed in one clinical visit and, instead, follow-up and/or detailed clinical investigations are necessary. The diagnostic gold standard for OA is SIC using a specific occupational agent in an exposure chamber. SIC is particularly indicated in the clinical setting where new causative substances with still unknown adverse respiratory sensitization potential are suspected. This gold standard is not applicable for large studies so, it was used mainly in case series or reports.The evidence levels to confirm irritant-induced work-relaated asthma or occupational COPD for the listed irritant agents, professions or worksites are frequently low with the major reasons being that high quality studies were missing and the quality of the available studies was low. Nevertheless, this knowledge is the best available and may help physicians to identify a suspected irritant agent as causative in irritant-induced work-related asthma and / or occupational COPD. As also recently stressed by Quint et al., implementing an evidence-based identification and regulatory process for OA will help to ensure primary prevention of OA. In cases of low evidence level of an agent that does not exclude a causative role, caution should be exercised and a more detailed diagnostic testing of relevant exposure should be performed.
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How Is Asthma Related To Chronic Obstructive Pulmonary Disease
- University of Nottingham
- Two new studies exploring the causes and treatment of asthma and chronic obstructive pulmonary disease could lead to the development of drugs to battle these debilitating conditions.
Two University of Nottingham studies exploring the causes and treatment of asthma and Chronic Obstructive Pulmonary Disease could lead to the development of drugs to battle these debilitating conditions.
Though they are different diseases, asthma and COPD affect the human body in a similar way. In asthma, allergens irritate the lungs, in COPD, this is done by cigarette smoke. This irritation inflames the sufferers airways, which the muscles then close, creating a narrowing effect.
Research done at the University over the past 15 years has found that the muscle layer in the airway is more complex than has traditionally been thought. As well as going into spasm during asthma and COPD attacks the muscle layer produces a wide range of mediators and cytokines proteins that act as chemical signallers when it comes into contact with allergens or cigarette smoke. In asthma and COPD sufferers, these proteins are produced by stimulation of airway muscle cell walls in the lungs, releasing intracellular signalling proteins called transcription factors which alter the DNA of the cell and activate messenger RNA. It is these transcription factors which activate the inflammation by causing release of mediators and cytokines.
Similaraties And Differences In Acute Exacerbation Of Asthma And Copd
Pathology is different in exacerbation of asthma and COPD
Causes of acute exacerbation of asthma and COPD are different.
Different role of LABA and ICS in prophylaxis of exacerbation of asthma and COPD.
Treatment of acute exacerbation is similar in asthma and COPD.
Acute exacerbation of Asthma
Triggers of acute exacerbation of asthma are usually: allergens, infections , GE reflux, other triggers, sometimes and co-morbidity .
Pharmacotherapy of acute asthma exacerbation
corticosteroids . Other therapy
non -invasive mechanical ventilation
epinephrine rarely in a very serious asthma attack
He/Ox rarely and MgSO4 intravenously rarely.
Acute exacerbation of COPD
Triggers of acute exacerbation of COPD are usually: infections , airpollution, GE reflux, sometimes and co-morbidity .
Pharmacotherapy of acute COPD exacerbation:
antibiotics in patients with severe exacerbation Other therapy:
non -invasive mechanical ventilation .
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Asthma And Copd: What’s The Difference And Is There A Link
Asthma and chronic obstructive pulmonary disease are lung diseases. Both cause swelling in your airways that makes it hard to breathe.
With asthma, the swelling is often triggered by something youâre allergic to, like pollen or mold, or by physical activity. COPD is the name given to a group of lung diseases that include emphysema and chronic bronchitis.
Emphysema happens when the tiny sacs in your lungs are damaged. Chronic bronchitis is when the tubes that carry air to your lungs get inflamed. Smoking is the most common cause of those conditions .
Asthma gets better. Symptoms can come and go, and you may be symptom-free for a long time. With COPD, symptoms are constant and get worse over time, even with treatment.
Inflammatory Cells In Asthmatic Airways
Mast cells -activated mucosal mast cells release bronchoconstrictor mediatorshistamine, cysteinyl leukotriens, prostaglandin D2. They are activated by allergens through IgE receptors or by osmotic stimuli . Eosinophils are in increased number in airways, release basic proteins that may damage epithelial cells, and have a role in releasing a growth factors and airway remodeling , T lymphocytes are in increased number and release specific cytokines, including IL-4, IL-5, IL-9, IL-13 that orchestrate eosinophilic inflammation and IgE production by B lymphocytes . There may also be an increase in inKT cells which release large amounts of T helper: Th1 and Th2 cytokines . Dendritic cells,Macrophages are in increased number, and release inflammatory mediators and cytokines that amplify the inflammatory response . Nutrophils are in increased number in airways and sputum of patients with severe asthma and in smoking asthmatics, but the role of these cells is uncertain and their increase may even be due to steroid therapy .
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Diagnosing Asthma And Copd With Pft
I explained how a PFT can help diagnose asthma in my post at Asthma.net: What Are PFTs? I explained how a PFT can hep diagnose COPD in my post on this site, What Are PFTs?
So, if you read those, you know what an FEV1 is. You know how this can be used to determine if you have COPD. Still, heres a quick review. You do a PFT. You do a pre and post FVC. A computer determines your FEV1. This is the best indicator of airflow limitation.
You then use a bronchodilator. This can be either an inhaler or breathing treatment. Then you do a second FVC. Heres how you determine if its asthma or COPD.
- COPD. By its basic definition, its persistent respiratory symptoms and airflow limitation. Your pre and post bronchodilator FEV1 is less than 80%. Your post bronchodilator FEV1 is not much different than your pre bronchodilator FEV1. This shows that airflow limitation is persistent. It is not reversed with time or treatment. This confirms a diagnosis of COPD.1
- Asthma. By its basic definition, respiratory symptoms and airflow limitation are intermittent and vary in intensity. Asthma attacks are reversible with time or treatment. Your post bronchodilator FEV1 improves by 12% or more. This shows airflow limitation is reversible. This can help make a diagnosis of asthma. 2
- Asthma and COPD. This is when you have both. Your airflow limitation is reversible. But, your FEV1 remains under 80% despite treatment.
Is It Asthma Or Copd
A spirometry test, or pulmonary function test, can measure how well the lungs work. Individuals blow into the device as hard and as long as they can, providing information about how much air the lungs take in and expel. Many doctors use spirometry tests to measure airway problems associated with COPD and asthma.
Factors doctors look at when weighing a diagnosis with COPD or asthma include:
- A history of smoking: Most people with COPD are or were smokers.
- Age: Asthma often appears in childhood. If breathing difficulties occur after the age of 40, doctors are more likely to diagnose COPD.
- Symptoms: Coughing in the morning, heavy phlegm, and progressively getting worse suggest COPD. Recurring attacks, particularly if accompanied by allergies or eczema, suggest asthma.
- Family history: Asthma is more likely to run in families.
- Symptom triggers: People with COPD may have symptoms when they are active or at rest, without a known trigger. Asthma attacks may be caused by physical activity or something in the environment.
- Onset of symptoms: COPD tends to get worse over time, while asthma attacks come on suddenly.
- Responsiveness to treatment: Asthma tends to respond better to quick acting rescue inhalers than COPD does.
Diagnosis with either condition doesnt rule out developing another breathing disorder, so patients should report all symptoms to their doctor.
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Is It Asthma Copd Or Both
Both asthma and chronic obstructive pulmonary disease , including emphysema and chronic bronchitis, make breathing difficult. In fact, they share many similarities. However, they are different lung diseases. Asthma-COPD overlap syndrome is diagnosed when you have symptoms of both asthma and COPD. ACOS is not a separate disease, but rather a way for doctors to recognize the mix of symptoms and select a treatment plan that is most appropriate for you.
Recent Concepts For Asthma And Copd Treatment: Common Therapeutic Targets
Clinical recognition of the overlap between asthma and COPD is based on inflammatory features. Inflammation in asthma is associated with increased airway hyperresponsiveness, which leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in early morning. This inflammation is present even in those with very mild asthma and is unique in that the airway wall is infiltrated by Th2 lymphocytes, eosinophils, macrophages/monocytes, and mast cells. In contrast, the pathological hallmarks of COPD are destruction of the lung parenchyma and inflammation of the peripheral airways and central airways, along with parenchymal inflammation., There is a marked increase in macrophages and neutrophils in the bronchoalveolar lavage fluid and induced sputum., Given that asthma and COPD are both pulmonary disorders characterized by various degrees of inflammation and tissue remodeling, they present common therapeutic targets.
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More Than 40 Percent Of Women With Asthma May Develop Copd But Risk May Be Reduced
- American Thoracic Society
- More than four in 10 women with asthma may go on to develop chronic obstructive pulmonary disease , according to a study conducted in Ontario, Canada.
More than 4 in 10 women with asthma may go on to develop chronic obstructive pulmonary disease , according to a study conducted in Ontario, Canada, and published online in the Annals of the American Thoracic Society.
In “Asthma and COPD Overlap in Women: Incidence and Risk Factors,” Teresa To, PhD, and coauthors report that of the 4,051 women with asthma included in their study, 1,701, or 42 percent, developed COPD. On average, the women were followed for about 14 years after being diagnosed with asthma.
The researchers examined risk factors for developing asthma and COPD overlap syndrome, known as ACOS. Those who develop ACOS experience increased exacerbations and hospitalizations and have a lower quality of life, compared to those who have asthma or COPD alone.
“Previous studies have found an alarming rise in ACOS in women in recent years and that the mortality rate from ACOS was higher in women than men,” said Dr. To, a professor in the Graduate School of Public Health at the University of Toronto in Canada. “We urgently need to identify and quantify risk factors associated with ACOS in women to improve their health and save lives.”
However, ACOS did not affect only those who smoke: 38 percent of the women who developed ACOS in the study had never smoked.