Acute exacerbation of chronic lung disease tends to occur in the context of a particular form of chronic lung disease called chronic obstructive lung disease, abbreviated as COPD. COPD is a lung disease that incorporates aspects of chronic bronchitis and emphysema. Chronic bronchitis involves the constriction of airways and excess mucus production. Emphysema is the destruction of lung tissue. The most common cause is smoking. The disease is an ongoing problem that can have periods when the symptoms worsen greatly, requiring interventions beyond the standard care for a person's daily symptoms.
Oxygen
During the evaluation of an acute exacerbation of lung disease, an arterial blood gas may be indicated. This a measure of the gases such as oxygen as well as the acidity of the blood in an artery. It is likely to be performed if the individual appears to be suffering from shortness of breath. Primary treatment for low oxygen is the administration of higher concentrations of oxygen. Oxygen can be delivered by a nasal cannula, which is a plastic, two-pronged device that delivers oxygen through the nose. Various face masks are available to deliver even higher concentrations of oxygen. If a person is in respiratory failure, a breathing tube may need to be inserted into the airway to take over ventilation and deliver 100 percent oxygen, according to "Harrison's Principles of Medicine" by Anthony S. Fauci.
Bronchodilators
Bronchodilators are drugs that dilate the airways. Constricted airways in COPD make breathing more difficult. Dilating the airways reduces the work of breathing. Two common classes of bronchodilators are beta-agonists such as albuterol and muscarinic antagonists such as ipratropium. Beta agonists act on receptors responsible for causing the muscles in the lungs to dilate the airways. Muscarinic antagonists prevent the muscles from constricting the airways and dry up respiratory secretions.
Corticosteroids
Corticosteroids suppress inflammation in the body. The inflammatory reaction is an important component of the acute exacerbation of chronic lung disease. Inflammatory cells in the lungs signal for the production of mucus and narrowing of the airways. Typically, the bronchodilators discussed above can address these processes, but as the symptoms worsen, steroids become necessary to support treatment.
Antibiotics
Antibiotics are often given during exacerbations of chronic lung disease, since so many of these exacerbations are caused by underlying pneumonia. Certain symptoms such as fever increase the likelihood of infection and lower the threshold to use antibiotics.
References
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci et al; 17th Ed 2008
- "Current Medical Diagnosis and Treatment "; Stephen J. McPhee and Maxine Papadakis; 49th Ed 2010
