The spirometry results consist of obstructive disease. The most likely pulmonary disease is
COPD (chronic obstructive pulmonary disease), Emphysema (Regan, Lynch & Curran-Everret,
Emphysema causes injuries between the lungs and the alveoli, leading to the alveoli losing their
elasticity and trapping air between them. This results in extra air because of the lungs' difficulty
in expelling all the air. When there is a lot of air in the lungs, it becomes extremely difficult to
breathe, which contributed to the patient's dyspnea. Injury indicates that the alveoli that usually
hold up the airways and breathing can't open fully during breathing in and out. The injury may
also damage the alveoli walls, developing into larger, less efficient alveoli than smaller ones.
This decreases gas exchange in the lungs (GoldkLang & Stockley, 2016).
Some of the subjective findings found were that he was experiencing fatigue, which is one of the
major symptoms of emphysema. The patient had experienced dyspnea (shortness of breath),
which is another symptom of having COPD emphysema. The fact that he was a smoker also
indicates that it would have caused the condition (GoldkLang & Stockley, 2016).
Some of the objective findings were that his FEV1 (amount of air you can force from your lungs
in one second) numbers were below, suggesting that he had COPD. The fact that he had
bilaterally wheezes noted with forced exhalation along with a prolonged expiratory phase. He
also had a history of smoking, which is a major cause of this disease.
Management of the Disease
The disease's severity is moderate as the fev1 is between 50 t0 80; it's 69. The condition at this
point is considered stable.
Some medication classes recommended for the treatment of this disease are LABAs and
LAMAs, which are bronchodilators. Examples of LAMAs are Tudorza® (aclidinium), Seebri®
(glycopyrrolate), Incruse® (umeclidinium), and Spiriva® (tiotropium). Examples of LABAs are
Stiverdi® (olodaterol), Brovana® (arformoterol), Serevent® (salmeterol), Arcapta®
(indacaterol), and Perforomist® (formoterol).
LAMAs mechanism of action is that they prevent the bronchoconstriction reaction of adrenaline
on M3 muscarinic receptors in the air ducts smooth muscle; they have lengthened attaching to
M3 muscarinic receptors with rapid detachment from M2 muscarinic receptors. LABAs
mechanism of action facilitates fast bronchodilation reaction, which is the same as short-beta
agonists and a one-day bronchodilation reaction allowing the one daily dose. ( Calzetta, Matera,
Rogliani& Cazzola., 2018)
Some of the non-pharmacological treatments of this disease are flu and pneumococcal
Regan, E. A., Lynch, D. A., Curran-Everett, D., Curtis, J. L., Austin, J. H., Grenier, P. A., … &
Friedman, P. (2015). Clinical and radiologic disease in smokers with normal spirometry. JAMA
internal medicine, 175(9), 1539-1549. (doi:10.1001/jamainternmed.2015.2735)
Goldklang, M., & Stockley, R. (2016). Pathophysiology of emphysema and implications.
Chronic Obstructive Pulmonary Diseases, 3(1), 454. (doi: 10.15326/jcopdf.3.1.2015.0175
Calzetta, L., Matera, M. G., Rogliani, P., & Cazzola, M. (2018). Dual LABA/LAMA
bronchodilators in chronic obstructive pulmonary disease: why, when, and how.