• Give your own definition of COPD.

(Chronic Obstructive Pulmonary Disease) is a disease that consists of various grades and combinations of three specific obstructive airway diseases. These include: emphysema, bronchial asthma and chronic bronchitis.

• Briefly describe the proposed aetiology and pathophysiology of chronic bronchitis and emphysema.

Chronic bronchitis: The aetiology is idiopathic (of unknown source). The pathophysiology includes the vagus reflex (which is because of the stimulation of irritant receptors in the airways). It is important to note that an overactive parasympathetic nervous system plays an important role in chronic bronchitis.

Emphysema: The aetiology is cigarette smoking (especially in heavy smokers) or genetically susceptible individuals (for example persons with alpha 1- antitrypsin deficiency). The pathophysiology includes nonreversible dilation of the respiratory bronchiole and alveoli as a result of structural damage to the airways. The air is caught in the respiratory space of the lungs and is exhaled with difficulty, disrupting ventilation of the lung. There is sometimes a decrease in capillary blood vessel provision which further hampers gas exchange.

• Which types of therapy are included in the treatment of a COPD patient?

*Cessation of smoking,

*immunization against influenza and broad spectrum AB,

*bronchodilators to treat airway obstruction,

*mucolytics which dilutes the mucus,

*oxygen inhalation

*regular to moderate exercise.

• Why is ipratropium more effective in the treatment of chronic bronchitis than in the treatment of bronchial asthma?

Ipratropium is not anti-inflammatory, asthma has to do with inflammation which is why ipratropium is more suitable for chronic bronchitis`s pathophysiology is more about the vagus reflex than than that of inflammation.

• In which way do the skeletal muscle effects of theophylline have advantages in the treatment of COPD?

Theophylline improves the contraction function of the diaphragm, which increases the ventilatory capacity. It also helps to reduce hypoxia and dyspnea.

• What is the role of oxygen therapy in COPD?

Oxygen therapy helps to improve oxygen levels in the blood, which would help with the hypoxia and shortness of breath

Gee 'n kort en kritiese verduideliking van die rasionaal om fluvoksamien ('n selektiewe serotonienheropname remmer (SSRI) te gebruik in die behandeling van Covid pasiente.  Jou antwoord moet toepaslike verwysings sowel as in-teks verwysings he.

Fluvoxamine is gevind om aan die sigma-1-reseptor in immuunselle te bind, wat lei tot verminderde produksie van inflammatoriese sitokiene.1 In 'n in vitro-studie van menslike endoteelselle en makrofage het fluvoxamine die uitdrukking van inflammatoriese gene verminder. 2 Verdere studies is nodig om vas te stel of die anti-inflammatoriese effekte van fluvoxamine wat in nie-kliniese studies waargeneem word, ook by mense voorkom en klinies relevant is in die omgewing van COVID-19.

Daar is onvoldoende bewyse vir die paneel oor riglyne vir behandeling van COVID-19 om die gebruik van 
fluvoksamien vir die behandeling van COVID-19 vir of teen dit aan te beveel. Resultate van voldoende, goed
ontwerpte en goed uitgevoerde kliniese toetse is nodig om meer spesifieke, bewysgebaseerde leiding te gee
oor die rol van fluvoxamine vir die behandeling van COVID-19.

Bronne

https://www.covid19treatmentguidelines.nih.gov