Clinical: The basics - Chronic obstructive pulmonary disease.

Effective management of COPD should preserve lung function and control exacerbations, says Dr Laurence Knott.

The term COPD embraces patients formerly diagnosed with chronic bronchitis and/or emphysema. The main feature is airflow limitation that is not fully reversible.

The prevalence of COPD is usually quoted as 1-2 per cent. However, a study conducted by the GP research unit in Manchester found an overall prevalence of 4.1 per cent.

Risk factors include smoking, occupational exposure to noxious gases and particles, and hereditary alpha1-antitrypsin deficiency.

Signs and symptoms

COPD should be considered in any patient over 35 with a history of smoking and respiratory symptoms, especially breathlessness on exertion, productive cough, frequent chest infections or wheezing. A history of weight loss or ankle oedema may also be significant.

Signs of respiratory distress may be present, with a fast respiratory rate, breathlessness on exertion, use of the accessory muscles of respiration and pursed lips when breathing. …