What is COPD?
Chronic Obstructive Pulmonary Disease includes chronic bronchitis and emphysema. COPD is a long-term disease affecting your lungs. There is swelling of the airways and more mucus secretion, limiting the air flow in and out of your lungs.
Who is at Risk for COPD?l Smoking is the leading cause of COPD
l Heavy exposure to second-hand smoke or other air pollutants
What are the Symptoms of COPD?l Cough with or without mucus
l Shortness of breath with normal daily activity
What Can You Do to Protect Your Lungs?Quit SmokingQuit Smoking and avoid second-hand smoke. Smoking damages your lungs and decreases the amount of oxygen circulating through-out your body. Ask your healthcare provider if you need help quitting.
Practice Good Oral and Hand HygieneBrush your teeth twice a day. Cough and sneeze into your sleeve or a tissue. Wash your hands often with soap and water.
Influenza VaccineIn the absence of allergy or other contraindication, the flu vaccine is recommended for all adults.
Pneumonia VaccineIn the absence of allergy or other contraindication, the pneumonia vaccine is recommended for adults age 65 and older, and adults ages 18 to 64 who smoke, live in a nursing home, or have high-risk conditions such as diabetes, heart disease including heart failure, lung disease including asthma or COPD, kidney disease, alcoholism or liver disease, sickle cell anemia, or weak immune systems.
How is COPD Treated?Breathing ExercisesWhile you are in the hospital, a respiratory therapist will teach you how to do breathing exercises.
Pursed-lip Breathingl With your mouth closed, breathe in slowly through your nose (count to 2).
l Pucker or purse your lips as if you were going to whistle. Breathe out slowly and gently (count to 4).
l Repeat until you are no longer short of breath.
Diaphragm Breathingl Lie down on your back with your knees bent. Support your knees with a pillow if needed. Place one hand on your chest and
l Breathe in slowly through your nose so that your abdomen rises or moves out against your hand. The hand on your chest
l Tighten your abdominal muscles, pulling your abdomen in as you breathe out through pursed lips. The hand on your chest
NutritionCOPD patients burn more calories. Talk to your doctor or dietitian about maintaining a healthy weight, what’s best for you and foods to avoid.
l Take small bites, eat slowly, and chew your food well.
l Drink extra fluids to loosen and cough up mucus (ask your doctor if you have fluid restrictions for another condition such as
Oxygen TherapyYour doctor may prescribe oxygen therapy. You may need oxygen therapy at all times, just during activities, or when sleeping. Never change the flow rate without your doctor’s approval.
l Others who smoke need to smoke outside.
l Place a “No Smoking / Oxygen in Use” sign at your home.
l Stay 15 feet away from open flames such as candles and fireplaces.
l Use water-based lubricants on your hands and face. Do not use petroleum-based lubricants such as ChapStick® or Vaseline®.
l Check your smoke detectors regularly and get a fire extinguisher.
l Talk to your oxygen supplier about safe handling and proper use.
MedicationsCOPD medications help you breathe easier, do more of the activities you enjoy, and experience fewer symptoms or flare-ups.
Bronchodilators relax and expand the tightened muscles around the airways, making it is easier to breathe.
There are two types of bronchodilators: beta agonists (which work on small airways) and anti-cholinergics (which work on large airways).
There are two types of beta agonists: fast-acting and long-acting. l Fast-acting beta agonists provide quick relief (3 to 5 minutes) when you are short of breath. They may also be used to prevent
symptoms caused by triggers such as exercise. These medications include:
l Long-acting beta agonists usually last about 12 hours and are considered maintenance drugs. These medications should
NEVER be used for quick relief of symptoms or taken more often than prescribed. They include:
l Side effects of beta agonists include heart racing or palpitations, shakiness, and nervousness.
There are two types of anti-cholinergics: short-acting and long-acting. l Short-acting anti-cholinergics take longer to work than beta agonists (about 15 minutes) but have less noticeable side effects.
l Long-acting anti-cholinergics last 12 to 24 hours and are considered maintenance drugs. These medications should be NEVER
be used for quick relief of symptoms or taken more often than prescribed. These medications include:
l Side effects of anti-cholinergics include dry mouth and dry cough. You may use a combination beta agonist and anti-cholinergic such as: l ipratropium/albuterol (Duoneb®) Anti-inflammatory medications or corticosteroids reduce airway swelling and mucus production, making it is easier to breathe. These medications are considered maintenance drugs, and should be taken daily even when you are feeling better.
It is important to rinse your mouth after using inhaled corticosteroid. Side effects include white patches or sores inside the mouth, dry mouth or throat, and hoarseness. You may use a combination long-acting beta agonist and corticosteroid such as: l fluticasone/salmeterol (Advair®) Expectorants are used to thin mucus, helping to clear your airways when you cough. Examples include: l guaifenesin (Mucinex®)
Take oral expectorants with 8 ounces (one glass) of water.
Rules of Thumb for Medication Use:l Always carry a list of your medications with you.
l Take your medication as directed. Ask your doctor, pharmacist, nurse, or respiratory therapist if you do not understand how to
take it, if you have problems with the medication, or if you cannot afford the medication.
l When taking different types of inhaled medications, it is generally best to take them in the following order:
1. Beta agonist 2. Combination long-acting beta agonist and corticosteroid3. Anti-cholinergic 4. Corticosteroid
Managing your COPD l When you start feeling short of breath, use your fast-acting or rescue inhaler. It will work quickly to help you breathe
l Your long-acting or maintenance inhaler must be used every day whether you feel short of breath or not. NEVER use
your long-acting inhaler as a rescue inhaler. Good to go! Call your primary care provider to discuss your symptoms. CAUTION! Call 911 or go to the Emergency Room!
Area 4: Molecular recognition in biomolecules Toxic effects induced by polyamine metabolites on melanoma cells: a new therapeutic approach Enzo Agostinelli Department of Biochemical Sciences "A. Rossi Fanelli" ℡: +39 06 49910838 - @: enzo.agostinelli@uniroma1.it The purpose of this research is to develop a new anticancer therapy against melanoma (M14), taking advantage o