A Comprehensive Report on Chronic Obstructive Pulmonary Disease (COPD)

This report provides a detailed overview of Chronic Obstructive Pulmonary Disease (COPD), a chronic inflammatory lung disease causing obstructed airflow. It discusses the two primary forms: chronic bronchitis and emphysema, along with their causes, including smoking and exposure to particulate matter. The report covers diagnostic procedures and various treatment options, such as bronchodilators, corticosteroids, and methylxanthines, emphasizing the importance of exercise, both high and low intensity, in managing the disease and improving the quality of life. The role of metabolic equivalents (METs) in assessing exercise intensity is also discussed. The report concludes by emphasizing the treatable nature of COPD and the importance of medication, exercise, and lifestyle management for patients.

Running Head: CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Chronic Obstructive Pulmonary Disease
Student’s Name
Institutional Affiliation

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Chronic Obstructive Pulmonary Disease
Also denoted as COPD, Chronic obstructive pulmonary disease is an inflammatory and
respiratory disease that affects the lungs leading to interference with the airflow to and from the
lungs. The obstructed airway breathing and thus among the symptoms are coughing, wheezing
sound and also the passage of mucus and sputum. COPD presents itself in two primary forms,
and one includes chronic bronchitis which is characterized by persistent coughing with the
passage of mucus. The second type is emphysema which involves the damage of the air sacs
leading to a shortage of breaths and thus difficulty in breathing. A patient can have COPD
manifested in one form; however, a combination of both types affects the majority of the people.
To severe cases, COPD can lead to and increases the risk of heart diseases and lung cancer.
COPD’s leading cause is the inhalation of the particulate matter, either emission from the
factories, dust, chemicals, fumes, and cigarette smoking. The cigarette usage lays the most
dominating causative of COPD (Centers for Disease Control and Prevention (CDC. 2012)). In
the exposure to the particulate matter, in this case, has to be in long time duration to the effect of
causing the development of the inflammatory lung disease. However, there are other factors that
can also cause COPD. Age, for instance, is one of them, here, COPD develops with aging and
thus people aged 40 years and above are at risk of COPD. Though in rare cases, COPD can also
be caused genetically through deficiency of the protein alpha-1-antitrypsin whose role is to
protect the lungs (Vestbo, et al., 2013).
After the diagnostic procedures of the COPD, which may include chest x-rays, scan and
even a series of laboratory tests, a patient can then start treatment (Vestbo, et al., 2013). It is
significant to note that COPD can be treated. Most common procedures of the ailment focus on
the management of the symptoms. Bronchodilators are one group of medication that can be

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prescribed to the patient that acts by opening the airway, making breathing easier. This type of
medicine comes in two main varieties; long-acting such as formoterol, arformoterol and
indacaterol just naming a few, then, the short-acting that include levalbuterol, albuterol and
ipratropium. The other type of medication prescribed is corticosteroids which are anti-
inflammatory, thus reduce the swelling, thus easing the airflow. Most common prescribed
corticosteroids include the budesonide and fluticasone that are inhalers and prednisolone in the
form of pills. There are those patients that simple corticosteroids and bronchodilators may not be
effective, and to such, methylxanthines are advocated. This medicine perceives two ways of
action, and that is, anti-inflammatory and dilation of the airway (Khdour et al., 2012).
Pharmaceuticals have it that methylxanthines such as theophylline which comes in the form of
pills or syrup have high efficacy. There is also a set of drugs that involves a combination of
different medicines. For instance, two bronchodilators such as glycopyrrolate and formoterol, or
a bronchodilator and a corticosteroid as it are in Advair which constitutes of salmeterol and
fluticasone (Dong et al., 2013). All these medications show side effects that include tremors,
increased heart rate and nervousness for bronchodilators; muscle weakness and weight loss for
corticosteroids are some of the side effects (López‐Campos et al., 2016). These effects all
interfere with the optimal physical exercise of the body. Thus, it is advised that upon the usage of
these medications, they are managed to avoid compromising the intensity intended for physical
activity
Beside medical practitioners, several comprehensive studies encourage the exercise since
it positively improves breathing. Moderating of physical activity can also be prescribed, but this
does not define inactivity for in such a case, the cardiovascular strength and performance
declines, making breathing extremely difficult. For these, there is a need to, therefore, define the

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most appropriate intensity that a patient with COPD can engage during the physical workout.
There are two common types of exercise that a COPD patient can engage, high and low intensity.
High-intensity exercise includes practices that are but not limited to running, cycling,
skipping ropes, hill walking and fast walking. Physiologically, this intensity of the training is
associated with improved activity endurance, physiological and biochemical body functionality,
cardiovascular performance and the general quality of life. This, therefore, denotes that a high-
intensity physical performance is of value to COPD patients. However, this is most significant to
the patients in the first and second stage of the disease who are capable of enduring the
performance. This is because, in these stages, the symptoms are less severe and endurable,
especially the breathing and the oxygen uptake. The effectiveness of the exercise also matches
with timing whereby, studies have it that COPD patient can do the task in thirty minutes type
three times a week (Stefanelli et al., 2013)
Low intensity, on the other side, involves activities that include mild water workouts,
yoga, moderate walking, and swimming. These activities are less vigorous when compared to the
high-intensity ones and thus are advocated people with severe and extreme stages of COPD. This
is because such patients have reduced oxygen uptake and thus may strain in catching breath upon
less strenuous practices. When the outcome of patients on low-intensity exercise is compared to
the inactive ones, the results between the two are significantly different. Just like the high-
intensity performance, there was an improvement in the degree of oxygen uptake, muscle
intensity and also the quality of life. It is therefore sufficiently enough to note that, to the COPD
patient, both high and low-intensity workout plays a great role in the management of the disease
and improving the quality of life. Other benefits of exercise may include reduction of blood

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pressure, stress and depression management and strengthening bones. Thus the COPD patient
can attain the normalcy living while on medication and regular exercise.
With such comprehensiveness in mind, it is thus easy to make a fitness program for
patients with COPD. The questions to be answered help evaluate the safety of the patient before
engaging in the actual performance. These questions are; the type of exercise to chose and avoid,
how often, and the time schedule of taking medication. The intensity of the performance should
always start from low to high, depending on en can be evaluated using the METs. For example, a
mild and moderate COPD patient should start with simple stretching, to steady aerobics and
strenuous gradually. In regards to the frequency of the workout, all patients would gradually
exercise between 20 to 30 minutes session in the duration of 3 to 4 times a week for successful
results. The fitness program should also not interfere with the schedule for taking the
medications (Donaire-Gonzalez et al. 2013).
A metabolic equivalent (METs) is a terminology used to measure the intensity of a
physical activity that a person engages in. A single unit of METs is equal to the total calorie
expenditure when a person is sitting down. Therefore, physical activities from mild to severe
ones are equivalent to 3-6 METs. Thus, light exercises such as walking and swimming are 3-4
METs, vigorous ones 5-6 METs and extremely vigorous ones more than 6 METs (Hikihara et al.,
2012).
In conclusion, COPD is a respiratory inflammatory disease that is treatable and
manageable but not curable. Therefore, patients are advised to manage the symptoms and side
effects of drugs, take medicines as prescribed, and engage routinely on physical exercise. This
helps in attaining the normalcy livelihood through improved quality of life. Discipline in

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successfully managing the condition helps a patient to balance between all that it takes, such as
taking drugs and physical workout.

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