Emphysema is a chronic (long lasting) condition in which the walls between the alveoli (air sacs) within the lung lose their ability to stretch and recoil, causing shortness of breath.
Under normal conditions, air enters the nose or mouth and travels down the air tube (trachea) to the main air passages (bronchial tube). These passages allow air to go into the right and left lungs. Each bronchial tube branches into smaller passages (bronchioles) and eventually into tiny air sacs (alveoli). It is through the alveoli that oxygen enters the bloodstream when we inhale and that carbon dioxide is expelled when we exhale.
In emphysema, the air sacs become weakened and can break apart. Elasticity of the lung tissue is lost, causing air to be trapped in the air sacs and decreasing the amount of oxygen that is available for the body, and also decreasing the amount of carbon dioxide (CO2) expelled from the lungs. Also, it is easier for the airways to be blocked, because normal respiratory function is lost.
In advanced emphysema, the individual must work hard to expel air from the lungs. Breathing can consume up to 20% of the individuals energy while at rest, making exertion very difficult.
Unfortunately, because emphysema develops gradually over many years, the individual may not experience symptoms such as shortness of breath until irreversible damage has already occurred.
Emphysema develops very slowly, usually after years of cigarette smoking. As the disease becomes worse, any amount of activity may cause difficulty breathing. Shortness of breath during activity or exercise is usually the reason that prompts a person with emphysema to see a doctor.
According to the American Lung Association, over 3.1 million Americans have emphysema, of which 91% are 45 years of age or older.
Smoking is the major cause, but with ever increasing air pollution and other environmental factors that negatively affect pulmonary patients, those numbers are on the rise.
Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease, is a general term for diseases that damage the lungs and includes emphysema and bronchitis (inflammation of the lungs). It is estimated that more than 16 million Americans have some form of COPD. COPD is the fourth leading cause of death in the U.S, claiming the lives of more than 120,000 Americans.
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types of inhalers
Dry powder-inhaler: Dry-powder inhalers are the most common inhalers used today. This type of inhaler does not need a propellant. Instead, the individual inhales the medicine so it can reach the lung. Children, people with severe emphysema and asthma and people suffering from acute (immediate) attacks may be unable to produce enough airflow to use these inhalers successfully.
Metered-dose inhaler: The most efficient way to get asthma medication into the airways is with a metered-dose inhaler (MDI). When used properly, about 12-14% of the medication is inhaled deep into the lungs with each puff of the MDI. They are especially important for delivering quick relief medication - short-acting beta agonists - that relieve an acute attack of emphysema. MDIs are also used to deliver some long-term control medications, including anti-inflammatories and long-acting bronchodilators, which are taken routinely to manage asthma and emphysema symptoms. An MDI is especially recommended for use with inhaled steroids because it reduces the amount of drug dispersed into the mouth, which reduces the risk of side effects.
Metered-dose inhalers are designed to release a pre-measured amount of medication into the lungs. There are several different types, but in general, they all have a chamber that holds the medication and a propellant that turns the medication into a fine mist. A button is pushed to force the medication out through the mouthpiece.
Medication that is inhaled acts more quickly than medication taken by mouth. It also causes few adverse effects because the medication goes directly to the lungs and not to other parts of the body.
If an MDI is not used correctly, symptoms may persist or worsen. Individuals who have trouble using the device correctly may use a spacer to help them get the medication they need. Spacers are attached to the mouthpiece, and they hold the discharged, pre-measured medication in a chamber until the patient breathes in. Spacers are recommended for young children and older adults who have trouble coordinating breathing and activating the MDI.
Nebulizer: A nebulizer is an electrical device that sends medicine directly into the mouth by a tube (or mask in children). This method does not require hand-breath coordination. The patient puts the prescribed amount of medication into the tube, and then places the tube in the mouth (or places the mask over the child's nose and mouth). Then the patient breathes normally until all of the medication is gone.