Site Loader

Table
of Contents
Introduction. 1
Pathophysiology. 1
Signs and symptoms. 2
Diagnosis. 2
Discussion. 3
Conclusion. 3
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Introduction

We Will Write a Custom Essay Specifically
For You For Only $13.90/page!


order now

Chronic
Bronchitis is the inflammation of bronchial tubes. It is a type of Chronic
Obstructive Pulmonary Disease (COPD). COPD is a lung disease characterized by
airflow restriction. COPD worsens over time if left untreated. Another type of
COPD is emphysema. Alveoli are damaged during emphysema. The most common cause
of chronic bronchitis is smoking. Smoking irritates and inflames the lungs.
Over many years, the inflammation leads to irreversible changes in the lungs.
These changes will be discussed in the pathophysiology section of this report.
Other causes include long-term exposure to air pollution, fumes, dust, and
family history of chronic bronchitis.

 

Pathophysiology

Inhalation of noxious irritants,
primarily cigarette smoke, lead to inflammation of the bronchial tubes via
activation of epithelial cells in the lungs. Activated epithelial cells in turn
release inflammatory mediators, including tumor necrosis factor a and
interleukin 1ß.In addition, epithelial cells in the small airways release
transforming growth factor ß which is also an inflammatory mediator. These
inflammatory mediators draw additional inflammatory cells (monocytes,
neutrophils and lymphocytes) on to the site of inflammation in the lungs. Both
inflammatory cells and their mediators are involved inflammation.

 

 Long-term inhalation of noxious irritants
results in chronic inflammation of the bronchial tubes. Several changes in the
bronchial tubes and bronchioles of the lungs occur due to the ongoing
inflammation. Changes such as hyperplasia of the goblet cells, enlargement of
the mucous gland ducts and hypertrophy of the mucous glands in the bronchial
tubes. These changes leads to hyper secretion of mucus in the bronchial tubes.
Overproduction of mucus in the bronchial tubes results in mucus impaction and
narrowing of the bronchioles.

 

Other changes includes edema, bronchial wall thickening,
squamous cell metaplasia and destruction of cilia. Bronchial tubes become more
prone to infections due to the destruction of cilia. Progression of the disease
is accompanied by development of fibrosis. Fibrosis along with excessive mucus
production, leads to even further restriction of airflow.

 

 

 

 

Signs and symptoms

Signs and symptoms of chronic bronchitis include excessive
sputum expectoration. The sputum could be clear, yellow, green or even blood
tinged. Chronic productive cough is also a sign of chronic bronchitis. The
cough should also last for three months in a year and at least for two years in
a row. Another symptom is dyspnea. It may originally be observed only during
exertion. Nonetheless, it eventually becomes noticeable with less exertion or
even at rest. Both wheezing and chest tightness are the less common signs and
symptoms of chronic bronchitis. Cyanosis could also be seen in patients with
severe chronic bronchitis.

 

Diagnosis

In order to be diagnosed with chronic bronchitis, the
patient should first be diagnosed with COPD. To diagnose COPD, the doctor will
begin by conducting a in-depth physical examination. During the physical
examination, the doctor will listen to the patient’s breathing patterns for
bronchitis-like breath, diminished or distant breath sounds. The doctor will
also check for bluish lips, significant weight loss and other signs of COPD.  To record patient’s medical history, the
doctor will ask if the patient is a smoker or an ex-smoker. The doctor will
also ask if the patient have been exposed to noxious irritants such as chemical
fumes, dust and second-hand smoke. In addition, the doctor will check if the
patient has a history of daily productive cough that lasts at least three
months in a year, for two years in a row.

 

The doctor will also conduct the spirometry test. It is the
“gold standard” test used to test for lung functions and airway obstruction by
measuring the size, airflow and volume of air in patient’s lungs. Forced vital
capacity (FVC) and forced expiratory volume in one second (FEV1) are two values
determined from the spirometry test. FVC is the maximum amount of air that can
be exhaled with force, it serves as a measurement of the function of airway,
lung volume, and lung elasticity.FEV1 is the maximum amount of air exhaled
within a second. To be diagnosed with COPD, the ratio of FEV1/FVC should be
less than 70%. The FEV1 value also determines the classes of severity. An FEV1 more
than 80% represents a mild case of COPD and an FEV1 of more than 50% but less
than 80% represents a moderate case of COPD. Lastly, an FEV1 of more than 30%
but less than 50% represents a severe case of COPD.

 

After being diagnosed with COPD, the doctor will conduct
several diagnostic tests to make a definite diagnosis of chronic bronchitis.
These diagnostic tests include chest x-ray, sputum examination, high resolution
computed tomography (HRCT) and arterial blood gas analysis. Chest X-ray is one
of the tests conducted to confirm the diagnosis of chronic bronchitis and it
rules out other lung diseases. During sputum examination, cells in the sputum
are examined. Sputum examination helps to find out the main cause of lung
problems and eliminates the possibility of lung cancer. High resolution
computed tomography (HRCT) produces high-resolution images of lungs. Lastly,
arterial blood gas analysis determines the amount of oxygen and carbon dioxide
in the blood, patients with hypoxia and hypercapnia often have chronic
bronchitis.

 

Discussion

Olodaterol is a new drug currently available in the market to manage
chronic bronchitis. Results from several phase 3 trials of olodaterol indicated
that olodaterol improved lung function compared to the placebo and it is also
comparable to formoterol, a drug that
already exists in the market to manage chronic bronchitis.

Olodaterol is available in countries such as Russia, Canada and even in
Singapore. It is a long-acting ?2 adrenergic agonist. It is used once daily and as a long-term
maintenance therapy. It works by binding and activating the ?2-adrenoceptors found on the airway
smooth muscle.  It is has an increased selectivity and affinity to the ?2-adrenoceptors. The activation of ?2-adrenoceptors results in the
relaxation of airway smooth muscle cells. This leads to bronchodilation.
Nasopharyngitis, dizziness, hypertension, arthralgia, rash and tachycardia are
the some of the side effects of olodaterol. Olodaterol is available in the form
of a soft mist inhaler and in the brand name of Striverdi Respimat.

 

Conclusion

In conclusion, chronic bronchitis cannot be cured but its
symptoms can be managed by pharmacological and non-pharmacological treatments.
There are also new drugs available in market to treat and slow the progression
of chronic bronchitis. An example of the new drug is olodaterol. There is still
ongoing research on chronic bronchitis to get a deeper understanding of it and
to develop more new drugs to treat chronic bronchitis. AstraZeneca, a
pharmaceutical company, is currently conducting clinical trials related to
chronic bronchitis. Nevertheless, chronic bronchitis is a preventable disease.
It can be easily prevented by not smoking and reducing exposure to fumes and
dust.

 

 

 

 

 

 

 

 

 

 

 Table
of Contents

Introduction. 1
Pathophysiology. 1
Signs and symptoms. 2
Diagnosis. 2
Discussion. 3
Conclusion. 3
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Introduction

Chronic
Bronchitis is the inflammation of bronchial tubes. It is a type of Chronic
Obstructive Pulmonary Disease (COPD). COPD is a lung disease characterized by
airflow restriction. COPD worsens over time if left untreated. Another type of
COPD is emphysema. Alveoli are damaged during emphysema. The most common cause
of chronic bronchitis is smoking. Smoking irritates and inflames the lungs.
Over many years, the inflammation leads to irreversible changes in the lungs.
These changes will be discussed in the pathophysiology section of this report.
Other causes include long-term exposure to air pollution, fumes, dust, and
family history of chronic bronchitis.

 

Pathophysiology

Inhalation of noxious irritants,
primarily cigarette smoke, lead to inflammation of the bronchial tubes via
activation of epithelial cells in the lungs. Activated epithelial cells in turn
release inflammatory mediators, including tumor necrosis factor a and
interleukin 1ß.In addition, epithelial cells in the small airways release
transforming growth factor ß which is also an inflammatory mediator. These
inflammatory mediators draw additional inflammatory cells (monocytes,
neutrophils and lymphocytes) on to the site of inflammation in the lungs. Both
inflammatory cells and their mediators are involved inflammation.

 

 Long-term inhalation of noxious irritants
results in chronic inflammation of the bronchial tubes. Several changes in the
bronchial tubes and bronchioles of the lungs occur due to the ongoing
inflammation. Changes such as hyperplasia of the goblet cells, enlargement of
the mucous gland ducts and hypertrophy of the mucous glands in the bronchial
tubes. These changes leads to hyper secretion of mucus in the bronchial tubes.
Overproduction of mucus in the bronchial tubes results in mucus impaction and
narrowing of the bronchioles.

 

Other changes includes edema, bronchial wall thickening,
squamous cell metaplasia and destruction of cilia. Bronchial tubes become more
prone to infections due to the destruction of cilia. Progression of the disease
is accompanied by development of fibrosis. Fibrosis along with excessive mucus
production, leads to even further restriction of airflow.

 

 

 

 

Signs and symptoms

Signs and symptoms of chronic bronchitis include excessive
sputum expectoration. The sputum could be clear, yellow, green or even blood
tinged. Chronic productive cough is also a sign of chronic bronchitis. The
cough should also last for three months in a year and at least for two years in
a row. Another symptom is dyspnea. It may originally be observed only during
exertion. Nonetheless, it eventually becomes noticeable with less exertion or
even at rest. Both wheezing and chest tightness are the less common signs and
symptoms of chronic bronchitis. Cyanosis could also be seen in patients with
severe chronic bronchitis.

 

Diagnosis

In order to be diagnosed with chronic bronchitis, the
patient should first be diagnosed with COPD. To diagnose COPD, the doctor will
begin by conducting a in-depth physical examination. During the physical
examination, the doctor will listen to the patient’s breathing patterns for
bronchitis-like breath, diminished or distant breath sounds. The doctor will
also check for bluish lips, significant weight loss and other signs of COPD.  To record patient’s medical history, the
doctor will ask if the patient is a smoker or an ex-smoker. The doctor will
also ask if the patient have been exposed to noxious irritants such as chemical
fumes, dust and second-hand smoke. In addition, the doctor will check if the
patient has a history of daily productive cough that lasts at least three
months in a year, for two years in a row.

 

The doctor will also conduct the spirometry test. It is the
“gold standard” test used to test for lung functions and airway obstruction by
measuring the size, airflow and volume of air in patient’s lungs. Forced vital
capacity (FVC) and forced expiratory volume in one second (FEV1) are two values
determined from the spirometry test. FVC is the maximum amount of air that can
be exhaled with force, it serves as a measurement of the function of airway,
lung volume, and lung elasticity.FEV1 is the maximum amount of air exhaled
within a second. To be diagnosed with COPD, the ratio of FEV1/FVC should be
less than 70%. The FEV1 value also determines the classes of severity. An FEV1 more
than 80% represents a mild case of COPD and an FEV1 of more than 50% but less
than 80% represents a moderate case of COPD. Lastly, an FEV1 of more than 30%
but less than 50% represents a severe case of COPD.

 

After being diagnosed with COPD, the doctor will conduct
several diagnostic tests to make a definite diagnosis of chronic bronchitis.
These diagnostic tests include chest x-ray, sputum examination, high resolution
computed tomography (HRCT) and arterial blood gas analysis. Chest X-ray is one
of the tests conducted to confirm the diagnosis of chronic bronchitis and it
rules out other lung diseases. During sputum examination, cells in the sputum
are examined. Sputum examination helps to find out the main cause of lung
problems and eliminates the possibility of lung cancer. High resolution
computed tomography (HRCT) produces high-resolution images of lungs. Lastly,
arterial blood gas analysis determines the amount of oxygen and carbon dioxide
in the blood, patients with hypoxia and hypercapnia often have chronic
bronchitis.

 

Discussion

Olodaterol is a new drug currently available in the market to manage
chronic bronchitis. Results from several phase 3 trials of olodaterol indicated
that olodaterol improved lung function compared to the placebo and it is also
comparable to formoterol, a drug that
already exists in the market to manage chronic bronchitis.

Olodaterol is available in countries such as Russia, Canada and even in
Singapore. It is a long-acting ?2 adrenergic agonist. It is used once daily and as a long-term
maintenance therapy. It works by binding and activating the ?2-adrenoceptors found on the airway
smooth muscle.  It is has an increased selectivity and affinity to the ?2-adrenoceptors. The activation of ?2-adrenoceptors results in the
relaxation of airway smooth muscle cells. This leads to bronchodilation.
Nasopharyngitis, dizziness, hypertension, arthralgia, rash and tachycardia are
the some of the side effects of olodaterol. Olodaterol is available in the form
of a soft mist inhaler and in the brand name of Striverdi Respimat.

 

Conclusion

In conclusion, chronic bronchitis cannot be cured but its
symptoms can be managed by pharmacological and non-pharmacological treatments.
There are also new drugs available in market to treat and slow the progression
of chronic bronchitis. An example of the new drug is olodaterol. There is still
ongoing research on chronic bronchitis to get a deeper understanding of it and
to develop more new drugs to treat chronic bronchitis. AstraZeneca, a
pharmaceutical company, is currently conducting clinical trials related to
chronic bronchitis. Nevertheless, chronic bronchitis is a preventable disease.
It can be easily prevented by not smoking and reducing exposure to fumes and
dust.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Post Author: admin

x

Hi!
I'm Sonya!

Would you like to get a custom essay? How about receiving a customized one?

Check it out