Thursday , June 17 2021

You can live well with COPD

Chronic obstructive pulmonary disease (COPD) affects 251 million people worldwide; Of them, about 10% are Mexicans.

COPD is a preventable and treatable common disease with persistent respiratory symptoms and airway obstruction due to abnormal airway and / or divine abnormalities, potentially and slowly leading to death and in Mexico growing, positioning itself as one of the first causes of mortality.

It is estimated that today some 64 million people in the world live with COPD.

This disease affects men as well as women, being more incidental in men, but more fatal in women than breast cancer.

Usually caused by significant exposure to harmful particles or gases such as tobacco and smoke smoke, indoor air pollution, biomass fuel used for cooking and heating medium, outdoor air pollution, and exposure to chemical products and dust (vapor, irritation and gases in the workplace).

Dr. Gabriel Escobedo Arens, a pulmonologist at the La Reza Medical Center, said it was a common respiratory disorder that symptoms cough with phlegm, chronic cough, shortness of breath, wheezing, chest tightness, fatigue, loss of sleep, decreased embalming and cognitive function. , Gradually reducing the quality of life of the sufferer and people around.

However, the expert noted that, if detected in the first phase of treatment with spirometry, this study measures the amount of lung air, can be preventable and can be treated. "The first thing, he said, is to stop smoking so the patient is offered inhaled inhaled bronchi such as tiotropium, the first long anticholinergic for more than a decade, the most effective, safe and safe drug in the treatment of COPD."

"However, some people continue with persistent symptoms, and therefore have a higher risk of exacerbations, episodes of instability that increase the progression of the disease and complicate the prognosis," he said. "There are several reasons why they occur, including that the patient is not treated with the appropriate medication because he does not use the inhaler facility properly or that has therapeutic abandonment.In all cases, the result is the same: absenteeism, greater number of medical emergencies, hospitalizations and death prematurely[i].

Only in 2017 COPD was among the top 10 leading causes of death in Mexicans over the age of 50, whereas cost studies in public health institutions indicate that for each hospital admission due to aggravation, patient costs vary between $ 140,000 and $ 400,000 pesos annually, regardless of therapist's salary and resources Other related. Therefore, from the moment the patient presents one or more outpatients for them, it is necessary for the doctor to initiate or, if necessary, the treatment program by combining two bronchodes: LAMA + LABA instead of as indicated by the latest Gold 2019 guidelines.

In this context, Dr. Ricardo Lemus Rangel, the graduate biologist, CMN La Raza, said that for the convenience of healthcare professionals and patients, since last year launched a novel double bronchodilator, a rapid and continuous action that combines the benefits of tiotropium (LAMA) and olodaterol, beta2-agonist andrenergic (LABA), which aims to alleviate symptoms, improve exercise tolerance and health status and reduce risks in terms of preventing progression of disease, prevent and treat exacerbations in mortality decrease and inhibit the constant or final use of oxygen.

Various experiments have shown that the combination of fixed doses of tiotropium + olodaterol provides additional benefits on lung function and quality of life than two drugs separately, in addition to offering greater efficiencies than the combination of inhaled corticosteroids (ICS) + LABA, and therefore is the only category of its intended gold standard Primary treatment or maintenance of COPD. "This dual bronchodilator reduces the difficulty of breathing and the use of rescue drugs, enabling the affected ones to walk, work, dance and even exercise, making them functional and independent."

Although the development of COPD can be delayed with timely and appropriate therapeutic intervention, the expert agreed that lack of adherence is the main cause of failure. For example, 6 out of 10 patients do not use prescription inhalers correctly, which increases the risk of complications. In this context, it is explained that the combination of tiotropium + olodaterol has the advantage of being administered through an easy-to-use inhaler device (Respimat) that produces a cloud of small particles so that, with one shot, the active substance comes directly to the action site.


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