Chronic Obstructive Pulmonary Disease

Etiology: COPD is a chronic, progressive disease that makes it difficult to breathe. It is a proressive disease so patients diagnosed with COPD can expect symptoms to worsen at different rates for each person. Chronic exposure to tobacco smoke, industrialized dusts and chemicals through the airways, urban pollution, genetics and high intake of cured meats are the risk factors that the disease follows. There is also speculation that COPD is a result from an autoimmune disease. With COPD there are four reasons that can cause syptoms together, or just one can occur in patients. The airways or air sacs loose elasticity, the walls between air sacs have been detroyed, airway walls become thick and inflammed, or more mucous is created in the airway that cause build up and cloggs the airways. (Rachel Davis)

Signs/Symptoms: Shortness of breath, wheezing, breathing through lips or pursed lips, feeling of not being able to get enough air, using the neck muscles to inhale, sputum, and persistant cough. In severe or advanced cases twitchingand headaches due to large amounts of carbon dioxide in the blood, and fatigue. Shortness of breath while doing normal activities is also a common symptom. In severe cases shortness of breath while at rest.(Rachel Davis)

Method of Diagnosis: There are several methods of diagnosis. A spirometry is a device that measures the amount of air that can be exhaled in one second with the first large breath of air, or the FVC (forced vital capacity) which is the total volume of a large breath that can be enhaled. A chest X-ray can also be used to determine COPD. A complete test of pulmonary function along with a gas exchange test can determine if a patient has COPD or other lung diseases. (Rachel Davis)

Risk Factors:
*Modifiable: Smoking or exposure to second hand smoke, occupation, changing diet to intake less smoked and cured meats. (Rachel Davis)
*Non-Modifiable:
genetics (Rachel Davis)

Prevention:Don’t smoke tobacco. It is the major cause besides genetic factors and environmental air pollution. (sara johnston)

Supplements Commonly Used: Supplemental oxygen is used in patients with severe COPD, that have low oxygen level in the blood. ( Rachel Davis)

**Labs Appropriate to Disease:•• Values in the disease: people with complications in COPD will see a lab value drop in the oxygen partial pressure in their arteries. As COPD worsens, the PaO2 can drop below 60 mm Hg; this level signals respiratory distress to the brain and it strongly activates the respiratory centers. When the PaO2 is below 60 mm Hg, a person hyperventilates in an attempt to reverse the hypoxemia by breathing in more oxygen.(sara johnston)
*Normal Values Range:Normal value ranges: Albumin: 3.5-5.0 gm/dL BUN: 8-23 mg/dl Calcium: 8.4-10.2 mg/dL Carbon Dioxide: 22-29 mmol/L Hemoglobin female: 12.1-15.6 g/dL Male 14.6-17.5 g/dL pH arterial 7.35-7.45 and venous 7.31-7.41 oxygen partial pressure in the blood 80-100 mm Hg (sara jonhnston)

*Nutritional Significance:**• Values in the disease: people with complications in COPD will see a lab value drop in the oxygen partial pressure in their arteries. As COPD worsens, the PaO2 can drop below 60 mm Hg; this level signals respiratory distress to the brain and it strongly activates the respiratory centers. When the PaO2 is below 60 mm Hg, a person hyperventilates in an attempt to reverse the hypoxemia by breathing in more oxygen. sara johnston

General Dietary Prescription:Protein needs are 1.2-1.7 g/kg of dry body weight. A balanced ratio of protein (15%-20% calories), fat (30%-45% calories), and carbohydrate (40%-55% calories) is important to preserve a satisfactory respiratory quotient (the ratio of volume of carbon dioxide expired to the volume of oxygen inspired. For people continuing to smoke, additional vitamin C may be necessary. The role of minerals such as magnesium and calcium in muscle contraction and relaxation may be important for people with COPD. Reduced bone mineral density has been seen in patients with COPD which provides evidence supporting the need of attention to the medical, surgical, nutritional, and exercise concerns related to osteoporosis. Additional Vitamin D and C may be necessary. Drinking plenty of water helps prevent gas when eating high fiber foods and thins the mucus so it will be easier to cough up. Limit alcohol (can make coughing up mucus hard) and chose non-caffeinated and non carbonated beverages. sara johnston

Specific Foods to Include:Vegetables, fruits, whole grains, dairy products, and proteins. High-fiber foods are especially important. They help with digestion, control blood sugar levels, reduce cholesterol levels, and can help control weight.

Specific Foods to Avoid: Smoked and cured meats they are linked to increase risk. (Rachel Davis) Avoid salt. Salt (sodium) makes your body retain water, which increases swelling. This makes breathing more difficult. To reduce your salt intake, try to: Read food labels and choose foods with fewer than 300 milligrams of sodium per serving. use no-salt spices. Avoid adding salt while cooking. Avoid foods that cause gas or bloating. Everyone knows how uncomfortable that full-stomach feeling is. And it makes breathing more difficult, too. To minimize gas or bloating, avoid foods and drinks such as: Beans, broccoli, Brussels sprouts, cabbage, and cauliflower, Carbonated beverages Fried, spicy, or greasy foods Avoid empty foods. Junk foods such as chips and candy don't provide any nutritional value. sara johnston

Reccomended Prescription Drug Therapy: Bronchodialators are drugs that expand and improve the function of the air ways, the most proven effective are Anticholinergics. These drugs relax smooth muscle by blocking the cholnergic nerve from any stimuliants. There are 2 types of prescription drugs used most commonly one that has short term effects, Ipratropium. The other has long term effects, Tiotropium. Corticosteroids are prescribed to reduce inflammation in th airways due to flare ups. They can reduce permanent damage on the lungs and airways because of inflammation. However they do not provide immediate relief and the are shown to be more effective on patients with moderate to severe COPD, and are often taken at the sametime as the Bronchodialators. The most commonly prescribed corticosteroids are prednisone, fluticasone and budesonide. (Rachel Davis)

Potential Food and Drug Interactions: Corticosteroids can interact with grapefruit or related citrus foods. Corticosteroids can cause a negative nitrogen balance due to pro catabolism so extra intake of protein will be needed. Beta 2 Agonist such as Albuterol should not be taken with any kind of alcohol because it can cause nausea, vomiting, headache and irritability. Avoid taking caffeine with Albuterol or any bronchodilators because it stimulates the nervous system. And depending on what type of bronchodilator the patient is taking high carbohydrate or high fat meals may need to be limited. sara johnston

General Nutrition Education Objectives or Goals: Patients that are underweight can incase air ways function and strength by increasing calorie intake. Overweight patients can reduce risk of flare ups by loosing weight to reduce pressure from chest and lungs, by adding physical and aerobic activity as tolerated to strengthen air way muscles. If you exercise to keep your respiratory and circulatory systems healthy and strong, aviod tobacco smoke and eat a healthy diet your risks of this disease are very small. (Rachel Davis)

Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-ShareAlike 3.0 License