What are these Conditions?

Chronic bronchitis and emphysema are characterized by chronically blocked breathing passages. Collectively, asthma, emphysema, and chronic bronchitis or any combination are called chronic obstructive pulmonary disease. Usually, more than one of these underlying conditions coexist; most often, bronchitis and emphysema occur together.

The most common chronic lung diseases, chronic obstructive pulmonary diseases affect an estimated 17 million Americans, and their incidence is rising. They’re more common in men than women, probably because, until recently, men were more likely to smoke heavily. Chronic bronchitis and emphysema don’t always produce symptoms and cause only slight disability in many people. However, these diseases tend to worsen over time.

What causes them?

Predisposing factors include cigarette smoking, recurrent or chronic respiratory infections, air pollution, and allergies. Smoking is by far the most important of these factors. Smoking increases mucus production but impairs its removal from the airways, impedes the function of airway cells that digest disease-causing organisms, causes airway inflammation, destroys air sacs in the lungs, and leads to abnormal fibrous tissue growth in the bronchial tree. Early inflammatory changes may reverse themselves if the person stops smoking before lung destruction is extensive. Family and hereditary factors may also predispose a person to chronic bronchitis or emphysema.

What are the Symptoms?

The typical person with chronic bronchitis or emphysema is a longterm cigarette smoker who has no symptoms until middle age, when his or her ability to exercise or do strenuous work starts to decline and a productive cough begins. Subtle at first, these problems worsen with age and as the disease progresses. Eventually, they cause difficulty breathing on minimal exertion, frequent respiratory infections, oxygen deficiency in the blood, and abnormalities in pulmonary function. When advanced, chronic bronchitis and emphysema may cause chest deformities, overwhelming disability, heart enlargement, severe respiratory failure, and death.

How are they Diagnosed?

A history of cigarette smoking plus the results of blood and pulmonary function studies help confirm these diseases.

How are they Treated?

Treatment aims to relieve symptoms and prevent complications. Because most people with chronic bronchitis or emphysema receive outpatient treatment, they get comprehensive teaching to help them comply with therapy and understand the nature of these progressive diseases. If programs in pulmonary rehabilitation are available, they should consider enrolling.

What can a person with chronic bronchitis or emphysema do?

Stop smoking and avoid other respiratory irritants.

Install an air conditioner with an air filter in your home.

If you’re taking antibiotics to treat a respiratory infection, be sure to complete the entire prescribed course of therapy.

Practice good oral hygiene to help prevent infection, and learn how to recognize early symptoms of infection. Avoid people with respiratory infections. Get Pneumovax (pneumococcal vaccine) and annual flu shots.

To help remove secretions, learn how to cough effectively. If you have abundant, tenacious secretions, have a family member perform postural drainage (repositioning to drain fluids) and chest physical therapy. (Ask your doctor for instructions on these techniques.) If your secretions are thick, drink at least 6 eight ounce glasses of fluid a day. A humidifier may aid secretion removal, especially in the winter.

To strengthen your breathing muscles, take slow, deep breaths and exhale through pursed lips.

If you’re receiving home oxygen therapy, make sure you or a family member knows how to use the equipment correctly. Don’t increase the oxygen flow or concentration above what the doctor prescribes because too much oxygen may eliminate your respiratory drive and cause confusion and drowsiness. You probably won’t need more than 2 to 3 liters per minute .

Eat a balanced diet. Because you may tire easily when eating, eat frequent, small meals and consider using oxygen, delivered by a nasal cannula, during meals.

Schedule rest periods throughout the day and exercise daily as directed by your doctor.

Docetaxel is insoluble in water. But it is soluble in a mixed solvent of polyoxyethylene castor oil and ethanol. Polyoxyethylene castor oil can release histamine in the degradation. It may cause allergic reactions. Allergic reactions occurred in the first or the second medication for most of patients. Almost all of them occur within 30 minutes after administration. Timely anti-allergy treatment can quickly relieve symptoms and will not cause serious consequences. So although docetaxel cost is reasonable and welcomes, patients should be cautious when using it in curing diseases.

The severities of allergic reactions caused by docetaxel are different. The light manifested as flushing, itching, urticaria, drug fever, a severe allergic reaction mainly hypotension, bronchospasm, asthma, and anaphylactic shock. Serious allergic reactions to the rate of 25% to 30%, pre-treatment routine to the glucocorticoid, diphenhydramine and H2 blockers by the incidence dropped to 1.5% ~ 3.0%. But the main symptoms of an allergic reaction to laryngospasm is not mentioned in the instructions of the class of drugs, clinicians should be alert to allergic reactions in the use of taxane chemotherapy. They should not just depend on drug manual guidance.

The laryngospasm is dangerous. Quickly diagnosis and differential diagnosis are particularly important. The following adverse reactions to docetaxel due to laryngospasm instant attack shortly after the start of the chemotherapy inspiratory dyspnea characterized with chemotherapy-induced phase identification; often before the onset of palpitations, shortness of breath, the main complaint, with blood pressure, migraine low heart rate and other symptoms; ECG manifested as sinus tachycardia, arrhythmia with ECG for identification; acute laryngeal edema: allergy caused by acute upper airway obstruction caused by difficulty in breathing, but the incidence of slow. In addition, the differential diagnosis should also be noted that patients with or without a history of other respiratory and circulatory system.

Anti-histamine treatment or slow down the infusion rate before chemotherapy of taxol pharmaceutical raw materials can significantly reduce allergic reaction, but still can not completely avoid a severe allergic reaction. To prevent an allergic reaction, should do the following aspects: asked in detail about the history of allergies, confirm whether the patient is allergic, do a history of record in the use of docetaxel chemotherapy; medication half an hour before intramuscular injection of diphenhydramine 20mg and intravenous cimetidine 800mg dexamethasone 10mg; ready to rescue medicines and equipment to respond rapidly to serious allergic reactions may occur; infusion bottles and infusion tube using non-PVC materials, and through the connected filters and then I slow intravenous infusion; chemotherapy during the close observation of patients with signs of change, especially within 30 minutes after the chemotherapy, more with the exchange of patient and psychological counseling. Once there are the suspects and allergic reactions, the drugs should be discontinued immediately and people should have symptomatic treatment.

The laryngospasm is abrupt onset. It will obstruct the upper respiratory tract and affect the respiratory function in short time. And the panic state will exacerbate hypoxia. If it is handled improperly, it will cause hypoxia or even death. If breathing difficulties and other symptoms occur in medication process, it should be distinguish with other serious adverse reactions. It needs a quickly diagnosis. Once the diagnosis of laryngospasm is clear, people should immediately stop the importation of all drugs and cut off the allergens. At the same time, the monitoring of vital signs should be closed. High-dose dexamethasone intravenous will inhibit allergic reactions. If there are serious wheeze, the merging bronchospasm should be considered and patients need to be injected with 0.25g of aminophylline and calcium gluconate intravenous to relieve the spasm of airway smooth muscle.