Monday , April 12 2021

You can live well with COPD



Chronic Obstructive Pulmonary Disease (COPD) affects 251 million people in the world; about 10% of them are Mexican.

COPD is a general preventive and treatable disease associated with persistent respiratory and air flow limitations due to potentially and slowly death from respiratory and / or alveolar abnormalities, and increased in Mexico, settling for some of the first causes of mortality.

It is estimated that at present approximately 64 million people live with COPD.

This illness affects men and women, as it is more male, but more deadly in women than breast cancer.

Generally, there is considerable exposure to harmful particles or gases such as tobacco and wood smoke, indoor air pollution, biomass fuel used for cooking and heating medium, outdoor air pollution, and exposure to chemical products and dust (vapors, irritants and gases at the workplace).

Dr. Gabriel Escobedo Arenas, a pulmonologist at IMSS's La Razra Medical Center, said that it is often a respiratory disease whose symptoms are cough, abdominal pain, chronic cough, shortness of breath, tingling, chest, fatigue, sleep disturbances, decreased amplitude and cognitive function and in extreme cases weight loss, reducing gradual suffering and human quality of life.

However, an expert said that if it is found early in the first level of treatment with spirometry, a study that measures the amount of lung without lung is preventable and treatable. "The first thing he said was to stop smoking by offering inhaled bronchients, such as tiotropium, the first long-acting anticholinergic, which has been the most effective, safe and safe medicine for over ten years in the treatment of COPD."

He claimed that despite this, they are those who continue with the ongoing symptoms, so they have a greater risk of being crushed (crises), episodes of instability that increase the progression of the disease and make predictions more difficult. "There are a number of reasons why they occur, including the fact that the patient is not treated with the appropriate medication that he or she does not use the appropriate inhaler device or that therapeutic rejection is in all cases the same result: absenteeism, more medical emergencies, hospitalization and premature death[i].

Only in 2017 COPD was among 10 over 50 years of leading death critics in Mexico, while the cost studies of public healthcare institutions show that the cost of receiving each hospital attendant from the hospital ranges between $ 140,000 and $ 400,000 per year, without taking into account the remuneration of the nurse and other related resources. Therefore, one or more hospitalization needs to be presented to the patient, so a doctor should initiate or modify the therapeutic formula if necessary by using a combination of two bronchodilators: LAMA + a LABA, monotherapy, as indicated by the recent update of GOLD 2019 guidelines.

In this regard, Dr. Ricardo Lemus Rangel, an adult lung cancer specialist CMN La Raza, said that the comfort of health professionals and patients has, since last year, launched an innovative double bronchodilator, a fast and prolonged action linking tiotropium (LAMA) and olodaterol, beta-agonist andrenergic LABA), which aims to alleviate symptoms, improve exercise tolerance and health, and reduce the risk of preventing progression, preventing and treating the exacerbation stages, reducing mortality, and slowing down standard or final use of oxygen.

Various studies have shown that a combination of fixed doses of tiotropium + olodaterol gives more benefit to lung function and quality of life than both drugs separately, in addition to providing more effective effects than inhaled corticosteroid (ICS) and LABA, making it the only classed GOLD- standard for the primary treatment or treatment of COPD. "This double bronchodilator reduces the risk of breathing and the use of rescue medication, enabling patients to walk, work, dance, and even exercise, making them work and independent."

Although the development of COPD may be delayed by timely and adequate therapeutic measures, the expert considered that lack of failure is a key cause of failure. For example, 10 out of six patients do not use properly controlled inhalers, which increases the risk of complications. In this regard, he explained that the combination of tiotropium + olodaterol has the advantage of being provided with an easy-to-use inhaler device (Respimat) that produces a cloud of small particles so that a single dose allows the active ingredient to enter the operating range directly.

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