1.  COPD has a different degree of combinations such as bronchial asthma, chronic bronchitis and emphysema. This limits the limit air flow as well as gaseous exchange.

2. Chronic bronchitis is a non-specific COPD that is characterised by increased mucus secretion, decreased mucociliary clearance, regular bacterial respiratory infections, structural changes in bronchial walls and a chronic cough due to thick mucus.

Emphysema is often developed from smoking and irritants. Irreversible widening of respiratory bronchioles and alveoli. Air is trapped in lungs which equals difficult expiration. A decreased capillary blood vessels. Impededs gaseous exchange.

3. Treatment includes stop smoking. You may develop bacterial infection such as influenza immunization and broad spectrum antibiotics which can be treated with tetracycline, amoxicillin, ampicillin erythromycin. In the airflow obstruction give bronchodialtors. In mucus secretion dilate mucus with rehydration and steam. In hypoxia give oxygen inhalation. In poor lung capacity light moderate exercise will help.

4. Beta-sympathomimetics can improve mucociliary clearance. Ipratropium inhalation is currently the first line of drug treatment for COPD, the bronchodiatory effect is better achieved with beta-sympathomimetics.

5. Theophylline improves the contraction function of the diaphragm, further improves cardiac contractions and improves ventilatory capacity.

6.  The combination of beta-sympathomimetic, ipratropium and Theophylline may help bring relief however corticosteroids may be given if the above medications don't work. Corticosteroids are mostly ineffective so if needed oxygen therapy should be given.