Treatment for lung disease

Treatment for lung disease may include:


Immune suppressants and corticosteroids
These drugs are used to suppress the immune system in some lung diseases that are caused by an over active immune system. They are often used to treat inflammation. Some patients can achieve fairly good control of their conditions on these medications. There are potential consequences to their use though, the side affects can sometimes be terrible. The power of corticosteroids should not be feared, but must be respected. One of the most common corticosteroids used in lung disease is Prednisolone.


Nebulisers
These are drugs in liquid form such as Salbutamol and Ipratropium which are turned into a fine mist that can be inhaled directly into the lungs. The majority of drugs delivered via nebuliser are to ease bronchospasms or ‘tightness’ of the chest and are often used when theres inflammation in the lungs.








Inhalers
These are delivery devices designed to deliver drugs directly into the lungs and minimise the effects to the other parts of the body. Many different drugs can be given via inhaler, the most common ones are corticosteroids, which are used to damp down airway inflammation, and bronchodilators of various types can be used to try and open up narrowed airways. Spacer devices are commonly used with children and those with poor technique.



Intravenous and Long Term Antibiotics
Typically used during chest infections but some antibiotics such as Azithromycin have been found to have anti-inflammatory properties and are used long term. Antibiotics may also be inhaled via a nebuliser.

Supplemental vitamins
People with severe lung disease may sometimes find it difficult to eat and may suffer from osteoporosis due to being treated with Immune suppressants and corticosteroids. If this the case they may require vitamins such as calcium to help bone growth.







Painkillers
Pain can be a feature of lung disease for many reasons, such as pain from pleurisy (inflammation of the lining of the lung), from rib fractures due to coughing, from overworked respiratory muscles or as a side effect of other medications. The exact painkiller used will depend on the patient and the cause of the pain; there are several different classes of painkillers and they may not all be suitable for someone with severe lung disease.

Supplemental oxygen therapy
Oxygen therapy benefits the patient by increasing the supply of oxygen to the lungs and thereby increasing the availability of oxygen to the body tissues. In severe lung disease the lungs ability to transfer oxygen into the blood stream becomes impaired leaving the patient feeling drained, breathless and sometimes blue (cyanosis). Oxygen should be considered a drug and the appropriateness of it and the dose in an individual patient needs should be decided by a doctor following tests of blood oxygen levels. The long term affects of low blood oxygen levels can include Pulmonary Hypertension and right sided heart failure. Oxygen can be delivered via nasal cannula and face mask and the amount should not be adjusted unless adviced by a doctor. Home oxygen for lung disease patients is now fairly common and readily available in the UK.



Non-invasive positive pressure ventilation (NIV)
In the late stages of lung disease and during type II respiratory failure carbon dioxide retention can become a problem. Carbon dioxide is dissolved back into the blood stream this in turn causes an imbalance in the blood PH level making the blood acidic. Very high levels of carbon dioxide can lead to tachycardia, seizures, coma, respiratory arrest and eventually death. NIV is used to help correct the imbalance of this gas within the lungs. NIV is usually delivered by a tightly sealed mask. There are various different settings and levels of support that can be given by most NIV machines depending on the specific lung disease and blood gas abnormalities.

Chest Physiotherapy and Pulmonary rehabilitation
Chest physiotherapy is generally performed by respiratory therapists, breathing is improved by the indirect removal of mucus from the breathing passages of a patient. Techniques include clapping or percussion: the therapist lightly claps the patient's chest, back, and area under the arms. Percussion, while effective in the treatment of infants and children, is no longer extensively used in adults due to the introduction of more effective and self-management focussed treatments. Pictured below is The Vest.

Getting out of breath can be very frightening, which makes the breathlessness worse. In trying to avoid this, people often reduce the amount of activity they do. However, this does not help, as over time you become unfit, tired and more breathless. Pulmonary rehabilitation can help by breaking that vicious cycle.

A typical pulmonary rehabilitation course includes:
• a gentle physical exercise programme, carefully designed for each individual
• advice on lung health and coping with breathlessness

	Gaye working hard at Pulmonary Rehab

Transplantation

In end stage lung disease lung or heart/lung transplantation maybe considered. When transplants are successful the patient may return to an almost normal lifestyle but there are potential problems, such as infection, recurrence of the original lung disease in some cases, and rejection of the organ.The transplant lists are often long with many patients unable to find suitable donors in time to save their lives.