Tuesday , April 20 2021

You can live well with COPD



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

COPD is a common disease that can be prevented and treated, with persistent respiratory symptoms and air flow restrictions due to abnormalities of the respiratory and / or alveolar pathways, which lead to a slow and slow death in Mexico increases, in itself, one of the first cases of deaths.

It is estimated that around 64 million people in the world are currently living with COPD.

This disease affects men as well as women, more men's occurrence, but more deadly in women than breast cancer.

It is usually caused by significant exposure to particulars or adverse gases such as tobacco and wood smoke, indoor air pollution, use of biomass fuel used for cooking and as a heating medium, outdoor pollution, and exposure to chemical products and dish (vapor, inflammation and gases in the workplace).

Dr. Gabriel Escobedo Arenas, Pulmonologist at the La Raza Medical Center, of the IMSS, is a frequent respiratory disorder whose symptoms are cough with plegm, chronic cough, breathlessness, wearing, chest tightening, fatigue , sleep loss, has reduced ambulatory and cognitive function and, in extreme cases, weight loss, slowly reducing the quality of life of the person suffering and those around the person.

However, the expert said that, if it can be stopped early at the first level of care with spirometry, a study that can measure the amount of air in the lungs can be stopped and treated. "The first thing, he says, is to give up smoking so that the respiratory bronchodilators of the patient are offered as a tiotropium, the first anticholinergic that has been a long time ago, more than a decade, the most effective, safe and safe medication when handling COPD. "

He argued, despite this, that there are still persistent symptoms, so they have a higher risk of aggravation (emergencies), episodes of instability that increase the progression of the disease and complicate its ragnosis. "There are a number of reasons why they occur, including the patient is not being treated with the appropriate medication, which does not use his / her very breathing device or then a therapeutic barrier. In any case, the result is the same: work absence, more medical emergencies, hospitals and premature death[i].

In 2017 only COPD was among the top 10 causes of death in Mexico over 50 years of age, while cost studies in public health organizations show that the costs per patient varied between each hospital because they were getting worse. $ 140,000 to $ 400,000 pesos annually, regardless of carer's pay and other related resources. Therefore, from the time the patient presents one or more hospitals for their case, it is necessary that the doctor starts, or needs adjusting, the therapeutic plan using & The combination of two bronchodilators: LAMA + and LABA rather than monotherapy, as indicated by the recent update of the ARI 2019 Guidelines.

In this regard, Dr Ricardo Lemus Rangel, adult lawyer CMN La Raza, said that for the convenience of health and patient professionals, since last year, he launched an innovative dual bronchodilator, a rapid and extended operation, which combines the benefits of tiotropium (LAMA) and olodaterol, beta2-agonic arenergic (LABA), which aims to relieve symptoms, improve exercise tolerance and health status and reduce risks in preventing disease progression, preventing and treating worsening and reducing deaths and constant or definitive oxygen use of oxygen.

Different trials have shown that the combination of fixed tottoos of sedotaterial tiotropium + provides more benefits on the function of the lungs and the quality of life than the two separate drugs, as well as offering greater efficiency or combination of breathing corticosteroids ( ICS) + and LABA, so here is only one of the designated AUR category standard in the basic treatment or maintenance of COPD. "This dual bronchodilator reduces the difficulty of breathing and the use of a rescue medication, which makes it possible for those affected to walk, work, dance and even practice , making it practical and independent. "

Although the evolution of COPD with timely and adequate therapeutic intervention could be deferred, the expert agreed that the main reason for failure is a lack of coherence. For example, 6 out of 10 patients do not use prescribed inhalers properly, which increase the risk of complications. In this regard, he explained that the combination of tiotropium + olodaterol has the advantage of being administered by an easy-to-use respirator (Respimat) that produces a cloud of small particles so that the active substance reaches, with one shot , directly to the operating site.

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