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Chronic obstructive pulmonary disease is an umbrella term that encompasses several respiratory illnesses that cause breathlessness, or the inability to exhale normally it is also refers to chronic obstructive bronchitis and emphysema. Both diseases limit airflow into and out of the lungs and make breathing difficult. COPD usually gets worse with time.
People usually experience symptoms, including shortness of breath, and normally cough up sputum (mucus from the lungs), especially in the morning. . Over time, the irritation causes the walls of the airways to thicken and develop scars. The airways may become thickened enough to limit airflow to and from the lungs. If that happens, the condition is called chronic obstructive bronchitis.
In a person with emphysema, the ruined air sac walls means less oxygen can pass into the blood. This causes shortness of breath, coughing, and wheezing.
Cigarette smoking, a main cause of COPD, has increased among women. One theory is that cigarette smoke is more damaging to women than to men.

Smoking Cessation and inhaled bronchodilator(LAMA-LABA) are mainstay of treatment of COPD
and monitored by Spirometry

first line Treatment of COPD

For patients with I COPD, bronchodilator therapy may be administered as needed to relieve acute, intermittent symptoms. Short-acting bronchodilators, such as albuterol and ipratropium, are appropriate, and may be administered either as monotherapy or together as combination bronchodilator therapy.

Patients with more severe stages of COPD can be expected to exhibit more frequent and persistent symptoms as the disease follows its normal course. Shortness of breath is one of the more readily apparent symptoms of COPD but may not be present in stage I. It is also important for healthcare providers to recognise that the development and/or worsening of dyspnoea may be masked in a patient who modifies his or her daily physical activities to avoid this symptom and accommodate the growing limitations on physical activity. As COPD progresses, patients may benefit from the introduction of long-acting bronchodilator therapy to prevent or reduce symptoms and maintain normal levels of physical activity. Long-acting agents have become the recommended first-line choice for maintenance pharmacotherapy for symptomatic COPD. 


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