COPD refers to chronic obstructive pulmonary diseases. These are common obstructive lung diseases and include emphysema, chronic bronchitis, asthma and which leads to the destruction of the respiratory tract. It is a major public health problem and is the fourth leading cause of morbidity and mortality in the United States of America and the fifth major cause of deaths worldwide.
It is essential to control COPD symptoms from worsening. There are 14 ways in which we can prevent COPD from worsening are:
14 Ways to Prevent COPD from Worsening
Avoid Cigarettes: -
To prevent COPD from worsening, it is important to stop any addiction to smoking cigarettes. Cigarette causes the depletion of a crucial enzyme causing alveolar wall destruction.
Arresting cigarette use suddenly can be really difficult. To prevent any withdrawal symptoms, use Nicotine replacement therapy by gums, transdermal patches or inhaler and antidepressant. It has been seen that it is quite effective and other drugs like varenicline also help to reduce smoke withdrawal symptoms.
More energy is required by people who suffer from the chronic obstructive pulmonary disease as muscles of respiration require ten times more energy than normal. Thus a good nutrition helps to fight infections and provide immunity and also goes a long way in preventing COPD from worsening. The following diet is recommended: -
- Increase fluid intake.
- Include high fibre food items like green leafy vegetables, fruits, dried peas, cereals etc. They help to provide better gastric motility and digestion it also prevents constipation.
- Reduction in salt consumption helps to prevent hypertension and oedema of limbs which is a common feature of COPD. As too much salt can also cause respiratory distress so use herbs and avoid salt intake more than 300mg.
- Vitamin-D and calcium supplemented diet are important to keep your bones healthy and also prevent respiratory distress due to muscle spasms.
- Various food items that should be avoided to prevent COPD from worsening are: -
- Carbonated beverages.
- Fried, greasy, or heavily spiced food.
- Apple and avocados.
- Beans, broccoli and soybeans, radish, scallions, cauliflower, peas, pepper, shallots and lentils.
Regular Exercising: -
COPD Patients really need to monitor their weight as:
If the patient is underweight it will make them tired easily, weak and make them more prone to infections. COPD patients usually require more energy for breathing and muscle movements so it is important to consume enough energy to prevent diaphragm and respiratory muscles from wasting and weakening.
In the case of obese patients who are overweight, they can be more prone associated cardiac symptoms and may develop diabetes which can worsen their situation.
So, daily exercise is required to maintain a healthy weight which can help prevent worsening of COPD.
Environmental Changes: -
COPD Patients should avoid unhealthy and polluted environment as all the allergens tend to sensitise the respiratory epithelium, cause dyspnea and cough leading to respiratory distress and thus causing worsening of COPD.
Use of chemical agents which includes hairsprays, air-sprays, perfumes and deodorants should also be avoided.
Vaccination should be done from time to time to prevent pulmonary infections. Some vaccines with pneumococcal and influenza viruses are available and widely used.
Inhalation of salbutamol 200 microgram or terbutaline 500 micrograms 6 hourly in mild to moderate cases can prevent COPD from worsening as these drugs prevent bacterial adhesions with the respiratory endothelium and stop them from damaging the respiratory endothelium so the condition of COPD does not worsen.
In severe condition ipratropium bromide and tiotropium bromide can be given.
Oral therapy with theophylline or doxophylline can be given.
Hot drinks and steam inhalation to liquefy sputum is a nice therapy for COPD. It can be done with salbutamol 200 microgram twice in a day. It helps to clear the nasal obstruction, improves respiration and prevents worsening of COPD.
Antitrypsin Therapy: -
Alpha-1-antitrypsin (α1-antitrypsin) also called as serum trypsin inhibitor is a protease inhibitor which protects the tissues of the body from the enzymes present in inflammatory cells. The deficiency of this alpha-1-antitrypsin cause elasticity of lungs which leads to many respiratory disease and COPD is one of them. So Alpha-1-antitrypsin therapy is given to people who have a congenital deficiency of this enzyme. This enzyme is helpful in preventing COPD.
Antibiotic Therapy: -
Antibiotic therapy includes a long list of drugs that help to prevent and provide relief for the symptomatic distress.
COPD patient can be treated with Cotrimoxazole or amoxicillin or fluoroquinolones like moxifloxacin, levofloxacin, or gemifloxacin and cephalosporin in severe cases. Oral tetracycline or ampicillin 250mg after every 6 hours is also used to treat and prevent the respiratory infections or worsening of COPD.
Steroid Therapy: -
Steroidal therapy is also helpful in preventing the worsening of COPD. In which steroids such as intravenous or oral corticosteroid should be administered as they shorten the recovery time and improve the function and capacity of lungs which can help prevent the hypoxemia.
Inhaled corticosteroids that are used to prevent the worsening of COPD include budesonide, beclomethasone, etc. They help to improve airway reactivity and cause slight weight gain.
Oxygen Therapy: -
Oxygen therapy is also a good way to avoid the worsening of COPD in which long-term oxygen therapy 2L/min by nasal cannula or by face mask can be given to the patients but it should be done carefully to avoid hypercapnia or hypercarbia which is the retention of excess carbon dioxide in the blood stream.
This helps to reduce pulmonary hypertension and increases the life expectancy of hypoxic patients and also in other diseases that include polycythemia, pulmonary artery pressures. As it increases dead space due to ventilation thus causing relief from vasoconstriction. It also increases oxygen binding capacity of haemoglobin thus reducing toxic carbon dioxide level.
The patient should get hospitalised immediately in medical conditions which lead to increase in symptoms like: -
- Resting dyspnea i.e. breathlessness on resting.
- Any new finding like bluish skin discoloration.
- Pedal oedema or any peripheral limb oedema.
- Cardiac symptoms like palpitation, chest pain etc.
- Lastly failure to respond to the already ongoing medical therapy.
Pulmonary Rehabilitation: -
The primary goal of pulmonary rehabilitation is to reduce respiratory and cardiovascular distress and dysfunction through individually designed programs which help in preventing the worsening of COPD.
Pulmonary rehabilitation can be done by practising various breathing techniques, chest physical therapy, postural drainage, exercise conditioning of upper and lower extremity and activities of daily living i.e. work simplification and energy conservation.
Psychological and vocational counselling along with nutritional needs and evaluation is also included in pulmonary rehabilitation.
Airway Ventilation: -
Airway Ventilation is done in severe cases of COPD with the use of tight fitting masks to provide ventilator assistance and is usually done when the symptoms are worsened like exacerbated dyspnea and respiratory acidosis etc.
Intubation is done as a last option to prevent the fatality due to worsening of the condition of a patient with COPD.
The treatment for COPD is a long-term procedure, to avoid any complications and fatal attacks the above-mentioned measures must be adopted by the patient.