COPD exacerbation; It is defined as periods when patients' complaints increase. Exacerbations are events that have significant negative effects on the course of the disease. Therefore, one of the main goals of COPD treatment is to prevent the development of exacerbations. During exacerbations, shortness of breath and cough increase, the amount of sputum increases and its color becomes darker. Some or all of these complaints may begin simultaneously in a patient. In addition to these, the following changes may be observed.
• Increase in wheezing
• Feeling of distress and irritability
• Edema formation in the hands and feet
• Insomnia
• Severe weakness and fatigue feeling
• Fever
• Feeling of palpitations
While exacerbations do not occur at all in some COPD patients It may occur several times a year in some patients. Patients usually have to apply to a healthcare institution during these periods. Generally, outpatient treatment can be done by increasing medications and adding new medications. However, in cases where exacerbations are severe, treatment is possible with hospitalization.
Sometimes, complaints may increase for a short time without COPD exacerbation. This situation is called a “bad day”. It may not always be possible to distinguish a bad day from a flare-up. We can list the things that can cause a bad day as follows.
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Extremely hot or cold weather
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Barometric changes
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Boredom, stress
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Allergy
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Going to high altitude
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Missing medications
What are the causes of exacerbations?
The most important cause of exacerbations are viral and bacterial infections of the respiratory tract. . Viral infections can facilitate the development of bacterial infections. For this reason, it is recommended to get the flu vaccine in October every year to prevent exacerbations. Other important causes of exacerbations: Staying in cold or polluted places for a long time, sinus infections, not using medications regularly and using respiratory devices with the wrong technique.
How are exacerbations treated?
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The doses of respiratory stimulants are increased.
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Antibiotics are started.
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Cortisone can be started for a short time.
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Plenty of fluid intake and rest at home are recommended.
Patients usually feel that a flare-up will begin. During this period, it is important to go to a health institution without delay and start treatment early. If there is a delay in the treatment of exacerbations, the exacerbation may become severe enough to require hospitalization.
Drugs are generally administered intravenously in hospital treatment of exacerbations. Abundant fluid intake is encouraged and at the same time, fluid intake is increased with serum. Medications used at home through the respiratory tract are discontinued and instead, respiratory stimulants are administered with devices called nebulizers. If necessary, long-term oxygen therapy is started. If adequate oxygenation cannot be provided with oxygen during exacerbation periods of COPD patients in severe stages, mechanical ventilator treatment can be started in the hospital room or intensive care unit.
When are antibiotics used?
Sometimes short-term antibiotic use may be needed in the treatment of exacerbation. Antibiotic use is necessary because darkening of the sputum and its color turning yellow-green are considered signs of infection. Due to the risk of development of resistance to antibiotics in bacteria, the use of excessive and very strong antibiotics should be avoided. Antibiotic treatment should be used under the recommendations and control of the doctor.
What can be done to prevent exacerbations?
Exacerbations are events that accelerate the worsening of COPD disease. Therefore, one of the most important goals of COPD treatment is to prevent exacerbations. Things that patients (especially patients in severe stages) should pay attention to in order to prevent exacerbations:
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Quitting smoking and the use of all tobacco products
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Cleaning hands washing with soap frequently
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Paying attention to dental and oral health
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Stop greeting by hugging
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Not being in crowded environments
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In areas with heavy traffic not walking
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Avoiding being outdoors as much as possible in extremely cold and hot weather, when air pollution is high
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Air pollution and cold Using dust masks with high protection properties to protect from the weather.
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Getting vaccinated
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Using medications regularly
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Using respiratory devices with the correct technique
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Do not give up physical exercises and walks
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Pay attention to nutrition to
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To treat reflux disease and to follow the reflux diet
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