Clinician's Guide to Chronic Obstructive Pulmonary Disease (Hodder Arnold Publication)

145 Pages·2005·4.74 MB·English

by  Timothy Q. Howes

CLINICIANS’ GUIDE TO
CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
This page intentionally left blank
CLINICIANS’ GUIDE TO
CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
Timothy Q. Howes MA MBBS MRCPI MD
Consultant Respiratory Physician
Department of Respiratory Medicine, Colchester General
Hospital, Colchester, UK
With a contribution from
David Bellamy MBE
General Practitioner
Bournemouth, UK
Hodder Arnold
AMEMBER OF THE HODDER HEADLINE GROUP
First published in Great Britain in 2005 by
Hodder Arnold, an imprint of Hodder Education, a member of the Hodder Headline Group,
338 Euston Road, London NW1 3BH
http://www.hoddereducation.com
Distributed in the United States of America by
Oxford University Press Inc.,
198 Madison Avenue, New York, NY10016
Oxford is a registered trademark of Oxford University Press
© 2005 Timothy Q. Howes
All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced,
stored or transmitted, in any form, or by any means with prior permission in writing of the publishers or in the case of
reprographic production in accordance with the terms of licences issued by the Copyright Licensing Agency. In the United
Kingdom such licences are issued by the Copyright Licensing Agency: 90 Tottenham Court Road, London W1T 4LP.
Whilst the advice and information in this book are believed to be true and accurate at the date of going to press, neither
the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made.
In particular, (but without limiting the generality of the preceding disclaimer) every effort has been made to check drug
dosages; however it is still possible that errors have been missed. Furthermore, dosage schedules are constantly being
revised and new side-effects recognized. For these reasons the reader is strongly urged to consult the drug companies’
printed instructions before administering any of the drugs recommended in this book.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress
ISBN-10: 0 340 816 953
ISBN-13: 978 0340 816 953
1 2 3 4 5 6 7 8 9 10
Commissioning Editor: Joanna Koster
Project Editor: Heather Fyfe
Production Controller: Lindsay Smith
Cover Design: Sarah Rees
Typeset in 11/13.5 Adobe Jenson by Charon Tec Pvt. Ltd, Chennai, India
www.charontec.com
Printed and bound in Italy
What do you think about this book? Or any other Hodder Arnold title?
Please send your comments to www.hoddereducation.com
CONTENTS
Preface vii
Acknowledgements ix
List of abbreviations xi
1. Definition and pathophysiology 1
2. Epidemiology of chronic obstructive pulmonary disease 13
3. Clinical diagnosis of chronic obstructive pulmonary disease 23
4. Disease prevention 41
5. Medical management 49
6. Chronic obstructive pulmonary disease exacerbations 81
7. Outcome measures 97
8. Chronic obstructive pulmonary disease at the primary–secondary
care interface 105
9. Case studies 119
Index 123
This page intentionally left blank
PREFACE
Chronic Obstructive Pulmonary Disease,Chronic Obstructive Airways Disease,Chronic
Bronchitis with Empysema,Chronic Airflow Limitation.The name changes but the dis-
ease goes on.Until recently the condition has hidden under the coat tails ofasthma,but
released from this constraint the momentum in this area ofinterest seems unstoppable.
It is likely that this little book will be out ofdate in some areas almost before it is writ-
ten.We hope however that it will offer a background for junior doctors and general prac-
titioners as well as nurses and physiotherapists interested in respiratory disease.This
condition is now ofgreat interest to health economists and planners and it is hoped that
they too will find subjects ofinterest.
The book has sections on the management ofchronic disease and acute exacerbations
and a section on the management of patients in general practice.There are many sec-
tions of interest to specialist nurses and physiotherapists who are shouldering an
increasing burden ofthese patients in pulmonary rehabilitation sessions.
An attempt has been made to improve the flow of the text by removing references
from the text and at the end ofeach chapter and adding a reading list for those readers
needing further information in a particular area ofinterest.As progress in this field is so
rapid,it is hoped that this will help readers to keep their knowledge up to date during
the life ofthe text.
This page intentionally left blank
ACKNOWLEDGEMENTS
Dr Howes is grateful for the support ofall ofthe team at the publishers.They have been
very tolerant ofever slipping deadlines and unexpected difficulties.Great thanks are also
due to Professor Wisia Wedzicha at St Bartholomew’s Hospital for constant advice.
Dr Howes is particularly grateful to his secretary Angela Humphreys for her help.