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Use in COPD

(Chronic Obstructive Pulmonary Disease (COPD)
COPD is a condition in the lungs that is usually caused by smoking.  It is the result of damage to the small airways (bronchial tubes) and alveoli (oxygen exchanging air sacs) leading to:
• Emphysema, in which the alveoli are damaged, resulting in non-functioning holes in the lungs
• Narrowing of the small arteries, restricting airflow in and out of the lungs and causing breathlessness
• Chronic bronchitis, which results in chronic cough that is productive of sputum (phlegm)

Symptoms vary in their severity from patient to patient and can Symptoms vary in their severity from patient to patient and can also vary from day to day in the same patient.  They include:
• Breathlessness
• Cough
• Sputum production

Exacerbations of COPD are episodes when the symptoms (breathlessness, cough and sputum production) deteriorate beyond the normal daily variability.  This usually requires a temporary new therapy or combination of new therapies and may include an increase in the usual inhaled treatments, a course of antibiotics or steroids to help the new symptoms resolve.  These episodes can be frequent.  They generally affect the general health of the patient making them feel less well even when the episode is over.  There is also a risk that exacerbations will cause the lung disease itself to progress.

Deciding which extra treatment to give (antibiotics, steroids or both) can often be difficult but antibiotics are only required if a bacterial infection is present.  The simplest way to tell this is by looking at the colour of the sputum:

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