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RiteFlo™ Can Be Combined With Rescue and Controller Inhalers Prescribed For Asthma, Bronchitis, Emphysema and COPD. 

What is COPD?

  • COPD stands for Chronic Obstructive Pulmonary Disease. COPD consists of three main progressive lung diseases: (1) Emphysema (2) Chronic Bronchitis and (3) Chronic Asthma
  • Smoking is the main cause of COPD.
  • Emphysema and chronic bronchitis are similar in their initial presentation. These patients have difficulty bringing oxygen to their lungs and removing carbon dioxide from their body.
  • Emphysema is the irreversible destruction to the walls of the small airways of the lungs. In chronic bronchitis, patients have excessive amounts of coughing and mucus or phlegm production.
  • Other causes of COPD include: passive smoke, pollutants, occupational dusts and fumes and respiratory infections as a child.
  • Another rare cause of COPD is Hereditary Emphysema or Alpha 1-Antitrypsin Deficiency. This is a disease where patients are born with a low level of alpha 1-antitrypsin (protein found in blood). These patients usually are in their early 40’s when they develop emphysema. Replacement therapy with plasma alpha 1-antitrypsin is the only FDA approved therapy for this disease.

How Common is COPD?

  • Unfortunately, COPD affects over 16 million Americans. Approximately 13.5 million patients have chronic obstructive bronchitis the other 2.5 million patients have emphysema. A national health survey suggests that as many as 24 million Americans may have COPD.
  • COPD is the fourth leading cause of death in America and the incidence continues to rise every year.
  • In developing countries, poor indoor air quality may play a major role in the development and progression of COPD.
  • In the year 2000, more women had COPD related hospitalizations (404,000) compared to men (322,000). More women had COPD related emergency room visits (898,000) compared to men (551,000).
  • In the year 2000, for the first time, more women (59,936) than men (59,118) died from COPD.

Risks For Developing COPD

  • Exposure to workplace fumes and dusts
  • Air pollution
  • Poor nutrition
  • Passive or second hand smoke
  • Uncontrolled asthma
  • Genetics (Alpha1– Antitrypsin Deficiency)
  • Smoking is the leading cause of approximately 90% of all COPD

How Does Cigarette Smoke Cause COPD?

  • There are many theories how the toxins in smoke induce inflammation in the lung, but no one theory has yet been proved. Over time, the toxins in smoke induce inflammation in both the bronchial walls and alveoli (this is where oxygen and carbon dioxide gas are exchanged in the air sacs of the lung).
  • The inflammatory changes both narrow and induce phelgm, resulting in swelling and spasm of the airways. The swollen airways are irreversibly damaged. These damaged airways cause airflow obstruction making it more difficult to breathe over time. Many patients begin to easily fatigue because they now must use more and more energy to breathe.

Do I Have COPD?

  • In the early stages it is difficult to diagnose COPD.
  • Early on, patients may not complain of shortness of breath, cough, or fatigue. This is why it is vital that you have your physician or health care professional perform spirometry (this is a computerized test that measures airflow in your lungs).
  • The volume of air expelled in the first second is called FEV1 (Forced Expiratory Volume in one second).
  • The full volume of air expelled over six seconds is called FVC (Forced Vital Capacity).
  • An FEV1/FVC ratio below 80% usually means a diagnosis of COPD.
  • Eventually, as the FEV1/FVC ratio goes down a patient develops the classic symptoms of COPD: cough with or without sputum production, shortness of breath, wheeze or dyspnea ( a sensation of breathlessness) and hypoxemia (low oxygen levels in the blood).
  • Acute infections or exacerbations (worsening of the disease) may produce rapid decline in lung function and even death from very low levels of oxygen.
  • All patients with COPD suffering from exacerbations need immediate expert care.

What Other Diseases Am I At Risk For?

  • COPD patients are at increased risk for developing the following illnesses: lung cancer, peripheral vascular disorders, coronary artery disease, heart attacks, cor pulmonale ( right heart failure) and strokes.
  • Patients diagnosed with COPD must be assessed for these disorders as well.

Can I Change The Course Of My COPD?

  • STOP SMOKING is the first and most important step in slowing down the decline in lung function and decreasing your risk of developing lung cancer.
  • Patients who have asthma if they use their inhaled steroids routinely can improve the course of their disease.
  • Most patients who participate in pulmonary rehabilitation programs and use their bronchodilators appropriately improve their overall health status.
  • Most patients with COPD have the chronic bronchitis form of the disease and not emphysema. Patients with chronic bronchitis may be able to reverse some of their disease.

What Medications Can Help Me?

  • There are two main type of bronchodilators prescribed for patients with COPD they are: (1) Beta 2– agonists (the most common is albuterol) Proventil Hfa®, Ventolin®, Maxair® (2) Anticholinergic antagonists (the most common is ipratroprium bromide and Tiotropium) called Atrovent® and Spiriva®.
  • These drugs have been shown to improve lung function, decrease symptoms, help to increase mucous clearance and reduce exacerbations (acute worsening attacks).
  • Most bronchodilators are in the form of hand held MDI’s ( Metered Dose Inhalers) which require coordination for proper inhalation.
  • Many patients may benefit from a spacer to aid in proer inhalation technique.
  • Some patients with COPD may benefit from prescription oral bronchodilators.
  • Patients who continue to worsen despite being on optimal inhaled bronchodilators may benefit from either oral or inhaled steroids. This decision must be made by your doctor.

What Is A COPD Exacerbation?

  • Briefly, an exacerbation is an acute worsening in the lung function and/or symptoms of a patient with COPD.
  • All patients with COPD eventually develop an exacerbation. Patients may complain of shortness of breath and or cough productive of discolored phlegm.
  • Patients develop more frequent exacerbations the worse their lung function is. The most frequent cause of an exacerbation is a respiratory infection.
  • Other causes of exacerbations are: (1) indoor/outdoor pollution (2) heart failure and (3) pulmonary emboli (blood clots to the lung).
  • The best way to deal with an exacerbation is to be prepared. Speak with your doctor or health professional to develop a plan when to call for help, increase your use of bronchodilators, maintain your vaccination status and most importantly keep your FEV1 as high as possible.
  • Many of the more advanced cases of COPD who develop an exacerbation (patients on supplemental oxygen) may need to be hospitalized. These patients often require chest X-rays and measurement of their blood oxygen and carbon dioxide levels.

What Else Can I Do To Help My Condition?

  • Vaccination is an important part of preventing serious infections. Every fall patients with COPD should get an Influenza vaccination.
  • Every five or six years COPD patients should get a Pneumonia vaccination.
  • Since respiratory infections are the most common cause of exacerbations (worsening of disease) do not hesitate to contact your physician for antibiotics if you have discolored phlegm.
  • Exercise and good nurtrition is an important part of keeping healthy especially if you have COPD.
  • Specific respiratory exercises such as: walking, inspiratory (breathing-in) muscle training, proper coughing (controlled) technique, pursed lip breathing all help to improve overall health status in patients with COPD.
  • Make sure your oxygen levels are not low. Many patients are not aware that they have low oxygen levels. Supplemental oxygen has been shown to extend the life of patients with COPD