Solving the Medication Organization Challenge
For people with chronic obstructive pulmonary disease (COPD), multiple medication bottles and inhalers are part of everyday life. Keeping them organized can be a challenge for them and their caregivers, which is why the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health (NIH), reached out to other caregivers to find out how they manage everything from the best places to keep everything to safe storage and proper utilization.
The Best Room
While bathrooms are convenient, many caregivers suggest they aren’t the best place to store medicines, particularly pills and other medications that are impacted by fluctuating temperatures and humidity levels.
“The kitchen is often a convenient place to store medication. Just make sure to keep medication away from heat sources, such as stoves and ovens, or even a sunny window,” states the NHLBI in its COPD Caregiver’s Toolkit. “Placing daily medications near items the person uses to start the day helps act as a reminder to take medications.”
Safe and Convenience
Safety is just as important as convenience when deciding where to store and organize medications. In particular, they should be kept out of the reach of pets and children.
Notes and Reminders
Caregivers should work together with the person they’re caring for by taking notes on using medication, oxygen, and other medical devices. These notes can act as reminders for future use. Be sure to also write down proper techniques for using oxygen devices or other medical devices.
“For new medications, such as a new type of inhaler, consider taking a picture and placing it with the notes to create a step-by-step usage guide,” suggests the NHLBI.
Storage Solutions
Finally, NHLBI offers the following storage solutions for safer medication management:
- Use a pill box to sort and store medications by the week or month and consider separate pill boxes for morning and evening pills.
- A small drawer unit with each drawer labeled is helpful if other family members are also taking medications and/or if medications need to be stored in the refrigerator.
- Try open baskets or bins that are clearly labeled to separate vitamins, cold remedies, and medications so no mix-ups occur.
- Open, stackable bins can save shelf space and allow more medications to be stored at eye height or a safe but reachable level.
More medication safety information can be found in NHLBI’s COPD Caregiver’s Toolkit, available here.
How Nebulizers Help Lung Conditions
Nebulizers, which turn liquid medication into a mist, are used to treat various lung conditions, including chronic obstructive pulmonary disease (COPD) and asthma. Vaporizing medications like albuterol, ipratropium, epinephrine, and corticosteroids helps people more easily and efficiently inhale it deep into their lungs.
Like an inhaler, a nebulizer works by delivering medication in a spray or a mist to make it easier to inhale. However, nebulizers are generally a better option for children than metered-dose inhalers because they require less effort. Too, a nebulizer has passive inhalation, which translates to less work for both adults and children. It can also be used for longer periods, making it a potentially life-saving device for someone suffering from a severe asthma attack.
A nebulizer consists of the machine, tubing, medicine cup, and mouthpiece or mask. Most work by using air compressors, which use air to convert the liquid into mist. There are also ultrasonic nebulizers, which use sound vibration instead. And while they can’t fit into your pocket like inhalers, many nebulizers are portable for on-the-go use although most require a battery or need to be plugged into an electrical outlet to function.
Additional insight from Dr. Nair: A misconception that people have about nebulizers is that they get their inhaled medication more effectively into the lungs as opposed to when they use a simple inhaler. In reality, they have the same effectiveness. A regular inhaler even has an advantage as it is easier and quicker to use. The caveat is the need for proper technique, which is a good breath hold. If you have a sudden episode of shortness of breath and you are breathing so fast you can’t hold your breath (classically for 10 seconds) or you are coughing, a nebulizer may be better. As always, talk to your doctor if you want to consider this option as every patient’s needs are unique.
To learn more about how to use a nebulizer, read more on MSN.
COPD and Lung Transplants
Lung transplants are often the final treatment option for people with severe chronic obstructive pulmonary disorder (COPD), offering increased life expectancy and higher quality of life for those with end stage COPD. However, lung transplants do not have the same rates of long-term success as other forms of transplant surgery and include a high occurrence of infection and rejection.
According to the International Society for Heart and Lung Transplant, a person must meet the following criteria to receive a lung transplant:
- the condition is worsening despite treatment
- enters a hypercapnic state (too much carbon dioxide in the blood)
- enters a hypoxemic state (too little oxygen in the blood)
- a forced expiratory volume in 1 second (the amount of air a person can force out of their lungs in 1 second) less than 25% lower than the value the doctor predicts would be had if the lungs were working normally
- Single lung, which involves a person receiving one lung.
- Double lung,
- Combined heart and lung, in which a person receives a heart and two lungs. This is generally only for people with either a congenital condition or a lung disease that has significantly damaged the heart.
A doctor may also consider placing a person on the lung transplant waiting list if they have a BODE index (Body-mass index, airflow Obstruction, Dyspnea, and Exercise) score of at least 80%, three or more severe COPD exacerbations in the past year, and/or moderate to severe pulmonary hypertension.
Short-term, the survival rates among lung transplant recipients are quite good – up to 92% of people survive for at least three months after the surgery. Research also suggests that lung transplants are the only intervention that can deliver long-term outcomes in people with very advanced cases of COPD, with roughly half of those receiving a lung transplant surviving for at least five years.
There are three types of lung transplant:
While there is currently no cure for COPD, for those with severe or end-stage COPD, lung transplantation offers a very real potential for improved quality of life.
Additional insight from Dr. Nair: When the doctor suggests undergoing a lung transplant evaluation, it is a scary proposition. But, as with all transplant surgery, it’s not something that happens immediately. It is a long and thorough process, and the wait for lungs is lengthy. The patient must also be extremely bad off, physically. A lung transplant is a lifelong commitment, but it can be miraculous.
To read the full article, visit Medical News Today.
New Hope for Emphysema Patients: Laser-Focused Steam Treatment For the Lungs
A quick blast of steam could give countless individuals who battle debilitating breathlessness a new lease of life. It’s a new procedure designed to help people with severe emphysema. According to reports, in as little as 15 minutes, doctors can treat damaged tissue in the lungs with a burst of heated water vapor, which scars the tissue.
As the scarred tissue shrinks over several days, space in the lungs is freed up, making it easier to breathe. Within weeks, the results suggest that patients are able to do more physically than they have in years.
The steam treatment was developed in the US. The procedure aims to improve the lives of patients with severe emphysema. The treatment is not a complete cure, but may relieve COPD symptoms, specifically helping sufferers walk further independently.
COPD damage reduces the amount of oxygen that reaches the bloodstream, causing breathlessness, coughing and fatigue. Eventually, healthy lung air sacs break apart and merge, causing gaps in the lungs. This leads to air getting trapped and causing the lungs to over-inflate, causing discomfort and making it even harder to breathe. with less room for fresh oxygen to enter the lungs.
The new treatment is called Bronchoscopic Thermal Vapour Ablation, or BTVA. It can target very specific areas and only requires moderate sedation.
After the treatment, most patients are kept in hospital for only one night and some are even well enough to go home the same day. The scar tissues shrinkage takes about four weeks from the time of the procedure. Until then, symptoms may worsen.
During the procedure, a tube containing a camera – a bronchoscope – is fed through the mouth to the lungs and to the worst affected area which needs to be treated. A balloon is passed through the tube to its tip, where it is inflated to block the airway. The obstruction means the steam reaches the targeted area only.
A dose of steam is then sprayed through a separate channel in the tube for between three and 10 seconds. After 20 seconds, the balloon is removed, and the airways are assessed. At most, two parts of the lungs will be treated at one time to avoid the risk of severe inflammation, which can cause further problems. The procedure can be repeated a few months later, to treat any additional parts of the lung.
The procedure is still in the research and testing phase, so may not be widely available, but shows promise as a possible treatment of COPD in some patients. To learn more, visit the Daily Mail.
Better Strategies Needed to Manage Patients Hospitalized with COPD, Atrial Fibrillation
The prevalence of atrial fibrillation increased in the United States from 2003 to 2014 among patients hospitalized with end-stage chronic obstructive pulmonary disease (COPD), according to results of a retrospective analysis.
“Better management strategies for patients with end-stage COPD comorbid with [atrial fibrillation] are needed, especially in elderly individuals,” Xiaochun Xiao, MPH, researcher in the department of health statistic at Second Military Medical University in Shanghai, and colleagues wrote in Chest.
Researchers evaluated data from 1,345,270 patients included in the 2003 to 2014 Nationwide Inpatient Sample. Xiao and colleagues assessed the prevalence of atrial fibrillation (AF) in patients with end-stage COPD on home oxygen admitted for COPD exacerbation. Several models were used to evaluate the association of AF with clinical factors, cost, length of hospital stay and hospital outcomes.
Of all patients admitted for COPD exacerbation, more than 18 percent had AF.
The primary outcome found is that temporal trend of AF prevalence increased substantially from about 13 percent in 2003 to more than 21 percent in 2014.
Patients with AF were more likely to be older (75 vs. 69 years), white (80 percent vs. 74 percent) and male (59 percent vs. 50 percent) compared with those without atrial fibrillation.
Comorbidities associated with increased prevalence of AF included congestive heart failure, valvulopathy, pulmonary circulation, chronic blood anemia and coagulopathy. AF was associated with increased healthcare costs and hospital length-of-stay, and was a risk indicator of stroke, in-hospital death, sepsis, acute respiratory failure and acute kidney injury.
“Our study represents the most current assessment of temporal trends and characteristics of atrial fibrillation among hospital encounters in the United States with end-stage COPD on home oxygen who were hospitalized for COPD exacerbation,” researchers wrote.
