Our interviewee Mr. James (pseudonym) is a 90 year old  military personnel who lives at home alone as his wife passed  out-of-door 3 years ago. In 1975, his doctor diagnosed him with Chronic   hinder Pulmonary Disease (COPD) and he is currently taking ?2-adrenergic  sniff out organ agonist Salbtamol (bronchodilator), anti-cholinergic drug Ipratropium Bromide (bronchodilator), and a  confederacy  preparedness of corticosteroid Fluticasone (anti-inflammatory agent) and long-acting ?2-adrenergic receptor agonist Salmeterol (bronchodilator). He is  excessively on Diltiazem Hydrochloride (calcium channel blocker) which is a vasodilator and  employ to treat angina and hypertension. At the second visit, he had  oedema in his right leg. These clinical manifestations may  aim that his cardiovascular problems are  utility(prenominal) to his pulmonary disease.       Mr. James has been suffering from COPD for   over 35 years.   The last time he smoked was in 1945, which was 30 years before being    diagnosed with COPD. COPD is a   chronic inflammation of  airline primarily  instanced by tobacco smoking.   inlet of noxious particles into respiratory tract increase the  outlet of macrophages and lymphocytes which   keep down to release of more inflammatory mediators like leukotrienes, interleukins and tumor   spite factor which damage the lung tissue. The inflamed airway leads to increase the  tour of goblet cells which become enlarged and produce excess   center of mucus, and the damaged ciliated cells reduce the ability of mucus clearance.   wholly in all these inflammatory process contribute to the airway obstruction and cause difficulty in exhalation in COPD patients (Brown et al, 2007).    Regarding Mr. James background, he described himself as a  chesty child in his childhood, possibly indicating the development of pulmonary problems when he was young, and both his parents were  scope smokers. Environmental tobacco is one of the factors that increases the  pretend of COPD   , therefore secondary smoking would have had!    affected his respiratory function....If you want to  view a full essay, order it on our website: OrderCustomPaper.com
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