Drugs for the Treatment of Emphysema

Definition

Pulmonary emphysema - or more simply emphysema - refers to a complex pathology of the lungs, responsible for a slow, progressive and inevitable respiratory difficulty, which tends to worsen over time. Emphysema involves a gradual reduction in lung volume, therefore it is denied the right supply of oxygen: this triggers the respiratory deficit.

Causes

In the vast majority of cases, emphysema begins together with chronic bronchitis: in this case, the disease takes the name of chronic obstructive pulmonary disease (COPD). The main cause underlying this complex pathological picture is undoubtedly smoking; other possible causal elements are associated with smoking, such as gas, old age, environmental pollution and genetic predisposition.

Symptoms

The intensity and violence with which the symptoms of emphysema manifest themselves essentially depend on the evolution of the disease and on the rather probable eventuality of a possible association with chronic bronchitis. Emphysema causes fatigue, weight loss, dyspnoea, loss of appetite, increased erythrocyte count, dry / catarrhal and wheezing cough.

The information on Emphysema - Medicines to Treat Emphysema is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Emphysema - Medicines for the Treatment of Emphysema.

Medicines

Being closely related to COPD, emphysema can have a fatal outcome, the main problem is that the first prodromes begin too late, when the disease is too advanced, leaving permanent damage.
Since smoking is the main cause of emphysema, it is evident that "abstention from smoking is a fundamental rule to prevent the disease or in any case to better address its recovery, when this is already underway. There are no pharmacological treatments to cure the disease definitively" emphysema: in addition to prolonging the health of the lung and slowing the degeneration of the disease, the main goal of treatment is to help the patient breathe better.

The following are the classes of drugs most used in therapy against emphysema and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

Bronchodilators: in the context of pulmonary emphysema, the use of these drugs has been shown to relieve cough symptoms and counteract breathing difficulties, although bronchodilators have no effect for complete recovery.

• Formoterol (eg. Oxis Turbohaler, Sinestic Mite, Symbicort Mite, Kurovent) is also available combined with mometasone, in the form of inhaled capsules (1 inhalation of 12 mcg every 12 hours) or as a solution to be inhaled (from 20 mcg to 2 ml. per vial, to be inhaled through a special nebuliser, with mask)
• Theophylline (eg. Aminomal Elisir, Diffumal, Respicur) theophylline is a xanthine drug used in therapy to reduce the broncho-constricting stimulus that often accompanies emphysema. Theophylline is indicated for the treatment of bronchitis and emphysema associated with " asthma: the drug should be taken at a loading dose of 5 mg / kg Consult your doctor.
• Difylline: generally, the drug is available in association with Guaifenesin, a substance with antitussive-expectorant activity. The dosage and method of administration of the drug must be established by the doctor. In any case, the drug is available in tablets-capsules (100-200 mg) or in solution (5-10 ml of active), to be taken orally, 3-4 times a day.

Inhaled steroids (eg sprays): used in therapy to relieve shortness of breath and breathing difficulties. It should be remembered that steroid drugs should not be taken in excessive quantities, nor are they recommended for long periods, as they can increase the risk of hypertension, diabetes, weakening of the bones and cataracts. Eg:

• Fluticasone (eg. Avamys, Alisade, Fluspiral, Nasofan) even if used extensively in therapy for rhinitis, the drug is equally useful for alleviating the typical symptoms of emphysema, thus helping the patient to breathe better. Patients previously treated with corticosteroids orally, they can take fluticasone at a dose of 880 mcg per day. Patients previously treated exclusively with bronchodilator drugs can take the drug at a dosage of 100 mcg on the first day, gradually increasing the dose from day to day, up to a maximum of 500 mcg twice a day.
• Beclometasone (eg. Rinoclenil, Becotide nasale) the drug, widely used in therapy against emphysema, should be taken by inhalation, at a dosage of 1-2 sprays (42-84 mcg) in each nostril, twice a day (168 -336 mg per day) The dosage just described refers to the spray drug, 0.042% solution.

Antibiotics: they are indicated for the treatment of emphysema if the disease is associated with pneumonia, acute bronchitis or other bacterial diseases affecting the respiratory tract

• Amoxicillin (ex. Augmentin, Klavux): belonging to the penicillin class; treatment with the drug should be continued for 7-10 days. The active ingredient should be taken at a dosage of 500 mg three times a day (alternatively, take 875 mg of the drug twice a day). Indicated for the treatment of pulmonary emphysema associated with uncomplicated pneumonia.
• Clarithromycin (eg. Biaxin, Macladin, Klacid, Soriclar, Veclam) take the drug at a dosage of 250-500 mg every 12 hours (in the case of suspected infection with Haemophilus influenzae, take 500 mg of the drug). Therapy should be continued for 7-14 days in the case of pneumococcal pneumonia in the context of pulmonary emphysema, and for 14-21 days for other infections.
• Tetracyclines (eg. Tetrac C, Pensulvit, Ambramycin): it is recommended to take this antibiotic to treat bacterial infection with chlamydia or Mycoplasma in the context of emphysema associated with influenza; the indicative dosage is 500 mg every 6 hours for 10-21 days , in relation to the nature of the infection.
• Azithromycin (eg. Azithromycin, Zitrobiotic, Rezan, Azitrocin): the drug (class: macrolides) should be administered at a dose of 500 mg to be taken orally on the day the symptoms appear, followed by a dose of 250 mg once a day. day for 2-5 days. The "antibiotic" must be taken when dealing with bacterial bronchitis associated with emphysema.

Smoking cessation medications:

• Varenclina (eg Champix, 25-28-56 tablets) take 0.5 mg of active orally once a day in the first three days of treatment to quit smoking. From the 4th to the 7th day of therapy, increase the dose to 0.5 mg of active twice daily. From the eighth day onwards, take 1 mg of active twice a day.
• Bupropion hydrochloride (eg Elontril, Wellbutrin, Zyban) start the treatment by taking 150 mg of active orally, once a day. Maintenance dose: The dosage may increase up to 300 mg per day (given in two divided doses during the day), no earlier than three days after starting therapy. For the purposes of healing emphysema, this drug has no direct effect; however, being an aid to quitting smoking, the intake of this active ingredient is still useful for relieving pulmonary symptoms.

Parallel Treatments for Emphysema

• Oxygen supplementation is an essential practice for patients suffering from advanced emphysema: in fact, the severe form of the disease involves severe breathing difficulties and oxygen deficiency in the blood; the use of oxygen therapy - not to be carried out exclusively in a hospital setting - guarantees immediate relief to the patient.
• In severe cases, surgery may be a "conceivable" option: treatment involves a reduction in lung volume, in which the micro areas of damaged / necrotic lung are removed. Again, the patient will be able to breathe with less difficulty.
• Lung transplant: represents the most desperate option, indicated for severe emphysema if the other forms of treatment - pharmacological and surgical - have not brought any effect.