You can live well with COPD

COPD is a common preventable and treatable disease, characterized by persistent respiratory symptoms and airflow limitation due to abnormal airways and / or alveoli, which can slowly lead to death and multiply in Mexico. , being one of the leading causes of death.

It is estimated that currently, about 64 million people worldwide have COPD.

This disease affects both men and women, being more common in men but more deadly in women than breast cancer.

Generally caused by significant exposure to harmful gases or gases such as tobacco and wood smoke, indoor air pollution, the use of biomass fuel used for cooking and as a means of heating, outdoor air pollution, and exposure to chemicals and dusts (vapors, irritants and gases at the workplace).

Dr. Gabriel Escobedo Arenas, pulmonologist at the La Raza Medical Center of the IMSS, said that it was a frequent respiratory disorder whose symptoms are coughing with phlegm, coughing chronic, shortness of breath, wheezing, feeling of chest tightness, fatigue, loss of sleep. , decreased mobility and cognitive function and, in extreme cases, weight loss, gradually decreasing the quality of life of the patient and those around him.

However, the expert indicated that, if detected early at the first level of care with spirometry, a study measuring the amount of air in the lungs could be prevented and treated. "The first thing to do," he said, "is to quit smoking to provide the patient with inhaled bronchodilators such as tiotropium, the first long-acting anticholinergic drug that has been in use for more than a decade. the most effective, safest and safest drug in the treatment of COPD. "

He argued that despite this, some patients persisted with persistent symptoms, so that they were at higher risk of exacerbations (seizures), episodes of instability that increased the progression of the disease and complicated its prognosis. "There are several reasons why they occur, including the fact that the patient is not treated with the appropriate medication, that he is not using his inhalation device properly, or that he is not using it properly. there is a therapeutic abandonment: in all cases, the result is the same: absenteeism at work, more medical emergencies, hospitalizations and premature death[i].

In 2017 alone, COPD was among the top 10 causes of death among Mexicans over the age of 50, while cost studies in public health facilities indicate that for each hospitalization due to exacerbation, per patient costs fluctuate. between 140 000 and 400 000 pesos a year, regardless of the remuneration of a health care provider or other associated resources. Therefore, from the moment the patient has one or more hospitalizations for his cause, it is necessary that the physician initiates, or modifies if necessary, the treatment regimen using the combination of two bronchodilators: a LAMA + an LABA instead monotherapy, as indicated by the recent update of the GOLD 2019 guidelines.

In this regard, Dr. Ricardo Lemus Rangel, Adult Pneumologist, CMN La Raza, said that, for the convenience of health professionals and patients, since last year, he has launched an innovative, fast-acting double bronchodilator. and prolonged. , which combines the benefits of tiotropium (LAMA) and olodaterol, a beta2-agonist andrenergic (LABA), which aims to relieve symptoms, improve tolerance to stress and to health status, as well as reducing the risks of preventing disease progression, preventing and treating exacerbations, decreasing mortality and delaying the constant or permanent use of oxygen.

Different trials have shown that the combination of fixed doses of tiotropium and olodaterol provides more benefits on lung function and quality of life than the two drugs separately, in addition to offering superior efficacy to the combination of an inhaled corticosteroid (CSI) + an LABA, so it is the only one of its kind to be designated GOLD standard for primary treatment or maintenance of the COPD. "This double bronchodilator reduces breathing difficulties and the use of rescue medications, allowing affected people to walk, work, dance and even exercise, thus making them functional and self-reliant. . "

Although the evolution of COPD may be delayed by timely and adequate therapeutic intervention, the expert agreed that lack of membership was the main reason for failure. For example, 6 out of 10 patients do not use prescribed inhalers correctly, which increases the risk of complications. In this regard, he explained that the association tiotropium + olodaterol has the advantage of being administered via an easy-to-use inhalation device (Respimat) that produces a cloud of small particles of so that on the site of the action.

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