COPD is noted as being the fourth leading cause of mortality in the United States. Mortality is expected to increase among COPD patients despite advances in its management. As exacerbations and hospitalizations characterize a key driver of the cost and morbidity of COPD, significance should be placed on interventions aimed at delaying the advancement of disease, inhibiting exacerbations, and reducing the risk of co-morbidities. Treatment for COPD has been at of a standstill in recent years. Beta2 antagonists, corticosteroids, and theophylline have been at the helm. However, nebulized furosemide has pushed its way from the background into the forefront recently.
A major cause of disability and anxiety, dyspnea is the most prominent…show more content…
Assuming that inhaled furosemide alleviates dyspnea principally through vagal mechanisms, it should be a possible treatment for dyspnea.
Overview of Chronic Obstructive Pulmonary Disease
Although not curable, chronic obstructive pulmonary disease (COPD) is a familiar, treatable, but avoidable disease that is still a huge health problem in the United States. According to the Global Initiative for Chronic Obstructive Lung Disease, “COPD is the fourth leading cause of chronic morbidity and mortality in the United States and is projected to rank fifth in 2020 as a worldwide problem according to a study published by the World Bank/World Health Organization.”1 Mortality from COPD is also expected to increase despite medical advances in the treatment of the disease.
Small airway disease found in chronic bronchitis, and parenchymal destruction found in emphysema contribute the chronic airflow limitation experienced by COPD patients. COPD reduces the sensory conduits maintaining both respiratory and cardiovascular systems.2 The sensory receptors that might play a substantial role in autonomic dysfunction in COPD patients are metabolic and pulmonary stretch receptors; central and peripheral chemoreceptors; cold receptors; arterial and cardiac baroreceptors; bronchopulmonary C-fibers; arterial chemoreceptors; four to five different types of airway receptors innervated by the vagus; slowly adapting stretch receptors