Pharmacological Management of COPD and Viral Infections

Running head: NURSING HARM
NURSING HARM
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Topic 1
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is generally an umbrella term that is used
to describe lung disease like chronic bronchitis, emphysema, refractory asthma and few forms of
bronchiestasis. The primary symptom of this disease is breathlessness. COPD can be caused due
to the long term exposure to lung irritants like obnoxious chemical fumes, industrial dust,
smoking or exposure to second hand smokes. Some inherited factors like alpha-1- antitrypsin
deficiency can also lead to COPD. Neonatal chronic lung diseases cause COPD in the later life.
Pharmacological management of COPD
The main aim of the pharmacological treatment of the chronic obstructive pulmonary
disease (COPD) is to prevent or to control the symptoms or reduce the severity of the
exacerbations. No medications can actually reduce the progressive decline of the functioning of
lungs. The pharmacological intervention of COPD is mainly symptomatic and involves
bronchodilators. Bronchodilators like selective beta adrenergic agonists, anticholinergics,
theophylline or a cocktail of these drugs are mainly used in the management of diseases.
Glucocorticoids are generally not recommended for patients with mild COPD and are suitable
for severe and frequent COPD attacks. Phosphodiesterase -4 (PDE4) inhibitors can be taken to
prevent the COPD exacerbations. Other medicines may include methylxanthines, used in severe
COPD, but they might have side effects and hence are generally avoided. New pharmacological
strategies needs to be developed due to the inadequacy if the older interventions. Tobacco,
biomass ad fuel induced oxidative stress is associated with the development of COPD, hence
targeting the local and the systemic oxidative stress with the help of antioxidants or enhancing

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the endogenous level of the antioxidants in the body can have beneficial effect on COPD
(Rahman, 2012). Antioxidants like thiol molecule can modulate different aspects related to
COPD. They can scavenge and detoxify the oxidants and the free radicals. They can also
regulate the glutathione biosynthesis and stop inflammatory gene expression in relation to COPD
(Rahman, 2012).
Nursing management in COPD
Nursing management involves assessing the patient's exposure to the triggering factors,
past and the medical history, vital signs, breathing patterns and sounds. For achieving the airway
clearance nurses must apply bronchodilators and the corticosteroids (Patel et al., 2012). Nurses
should help the patient to practice muscle raining and diaphragmatic breathing in order to
improve the breathing pattern. Suctioning can be provided in case patients are unable to cough
out the secretions. Well lubricated soft catheters can reduce the irritation and prevent trauma to
the mucous membrane. As the therapeutic intervention to the impaired gas exchange it is
necessary to let the patient sit in a semi fowler position for increasing the thoracic cavity and
lung expansion (Patel et al., 2012). furthermore he nurse should monitor any cognitive changes
in the patient, monitor the pulse oximetry values and should also educate the patient regarding
interventions like smoking cessation, use of facial masks and proper usage of the inhalers and the
bronchodilators during the COPD attacks.