Those asthma-like symptoms may be COPD

The lungs are vital organs of the body that function to exchange oxygen and carbon dioxide between the air we breathe and our blood.  Conducting this basic process of inhaling and exhaling air efficiently is essential to your health and well-being. 

When you inhale, the diaphragm, a large muscle below your lungs, contracts and moves downward.  This causes the lungs to expand and take in air.  During normal inhalation, air travels through the nose or mouth into the throat and down the windpipe.  From here, the air enters two bronchial tubes that lead to your lungs.  These tubes further divide into millions of smaller tubes that terminate in tiny air sacs throughout the lungs called alveoli.  Alveoli resemble clusters of grapes and serve to exchange gases between the air we breathe and our blood. 

Your airways are also lined with numerous types of cells.  Many of these cells function to prevent harmful particles such as dust, allergens, and bacteria from entering your lungs. 



What is asthma?

Asthma is described as a chronic inflammatory disorder of the airways that causes recurrent episodes of coughing, wheezing, chest tightness, and shortness of breath.  It usually develops in childhood, and is associated with allergic triggers (such as mold, dust, or pollen) in about 80 percent of patients.  In patients with asthma, these irritants cause an overreaction in your body that constricts the airways making it difficult to breathe.  This is known as an asthma exacerbation or asthma attack.



What is COPD?

Chronic Obstructive Pulmonary Disorder, or COPD, is the result of an abnormal inflammatory response of the lungs to noxious particles or gasses.  It is the fourth leading cause of death in the United States and has been associated with an increased risk for developing medical conditions like heart failure and pneumonia.  COPD usually develops in adults over age 40 who are longtime smokers, or who have had prolonged exposure to air pollutants such as cigarette smoke. 

COPD is a disorder characterized by chronic airflow obstruction due to emphysema and/or chronic bronchitis.  Emphysema is the disease process whereby alveoli are damaged and loose their ability to stretch when filling with air.  This causes a gradual destruction of the alveoli and ultimately results in one large air space within the lung that cannot efficiently exchange oxygen and carbon dioxide.  Chronic bronchitis involves the inflammation of bronchial tubes causing a swelling and narrowing of the airways.  Large amounts of mucus are also produced which further obstruct airflow.  In both of these conditions, the damage is permanent and causes scaring.



How are asthma and COPD diagnosed?

Both asthma and COPD are diagnosed using a series of exams known as pulmonary function tests.  These tests involve calculations of how well your lungs function.  They compare values such as how much air you can breathe in/out or how reversible your symptoms are with the use of a rescue inhaler.  Asthma and COPD have several other important differences between them (Table 1) and for this reason can only be diagnosed by a healthcare provider.  If you believe you are suffering from either of these conditions, consult your physician.



What can I do?

While neither asthma nor COPD are curable, they are treatable.  One of the most important steps you can take to manage your asthma or COPD is to stop smoking.  Quitting smoking can greatly slow the progression of these diseases.  Many healthcare providers also recommend patients keep a journal of their potential triggers for attacks.  By identifying triggers, you can more effectively manage your asthma or COPD and avoid exacerbations, leading to a better quality of life.  The last thing you can do is maintain a healthy lifestyle.  Proper diet and exercise will aid your lungs in functioning and help slow disease progression.  Part of a healthy lifestyle also includes making regular appointments with you doctor and keeping up to date on  vaccinations.



What prescription treatments

are available?

Currently, there are many prescription products marketed for the treatment of asthma and COPD.  Many of these medications, such as albuterol rescue inhalers, have important roles in the treatment of both disorders, however, each condition still has its own unique characteristics (Table 1).  These characteristics dictate several key differences in treatment approach.

When treating asthma, a typical regimen consists of an as needed rescue inhaler, like albuterol, and a class of drugs called inhaled corticosteroids, such as flutcasone or budesonide.  Albuterol belongs to a class of medications known as short-acting beta agonists.  These rapid-acting medications are used to treat attacks.  They affect receptors in the lungs which cause airway expansion and make it easier to breath.  Inhaled corticosteroids are longer-acting medications and work to prevent inflammation in the airways.  Depending on the severity of your condition, your doctor may also choose to put you on additional inhaled or oral medications to relax the muscles of your airways or decrease your body’s reaction to triggers.

COPD, like asthma, is also treated with rescue inhalers to help minimize symptoms of acute attacks.  In addition, COPD is treated with medications known as long-acting bronchodilators. 

These medications are broken into two classes, anticholinergics, such as tiotropium, and long-acting beta agonists, like levalbuterol or salmeterol.  These medications act to either prevent bronchial muscles from constricting or promote airway relaxation.  Patients suffering from COPD will often be on medications from both these classes depending on the severity of their disease.  Other treatment options for COPD include oral medications to prevent inflammation, oxygen therapy, and even surgical intervention.

However, these are just general treatment guidelines and are not necessarily the best option for everyone.  You should consult with your physician to determine the best treatment.



Comparison of Asthma and COPD



Asthma   

Onset is usually during childhood. 

Affects smokers and non-smokers.    

Symptoms include coughing, wheezing, chest tightness, and shortness of breath.   

Coughing is typically present at night and in the early morning. It is not always productive.   

Attacks are episodic and usually caused by an allergen or other trigger.  With treatment, attacks are normally quickly reversible.  Patients are typically symptom-free between attacks.   





COPD

Onset is usually in smokers over age 40.

Symptoms include coughing, wheezing, chest tightness, and shortness of breath, which are often persistent and progressive over time.  Many patients must use the muscles of neck and chest to aid in breathing.

Coughing is usually productive and often present throughout the day.

Attacks are progressive and usually caused by infection.  With treatment, symptoms are still largely irreversible and are often continuous as the disease progresses.



Goals of Therapy:

Prevent progression of the disease.

Preserve or improve lung function.

Prevent exacerbations or attacks.

Minimize the use of rescue inhalers.