How to treat COPD in a 63-year-old with other lung ailments?

Question

Hello doctor,

My mother is 63 years old. She is having severe cough for more than a year, and last year, she was admitted to the hospital. The doctors gave oxygen O2 therapy and bilevel positive airway pressure (BiPAP) for four months, and she was fine for a few months. Again, the severe cough along with sputum started. Recently, the doctor did some tests and gave medication, but she still has a cough and water collection in her legs. It seems that there is a problem with her heart as well. I have attached the current medication along with recent reports. Her oxygen levels are around 70, and her blood pressure (BP) is around 150 to 160 mmHg. Her sugar levels are under control. Currently, we are giving oxygen using the concentrator machine. Her condition is still not improving. Please let me know her prognosis. How to get her cured?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have seen all her reports (attachment removed to protect patient identity). Her diagnosis is COPD (chronic obstructive pulmonary disease) with cor pulmonale and PAH (pulmonary arterial hypertension). If her SpO2 is 70 % by a pulse oximeter, then she should be admitted to a hospital immediately. Normal saturation by a pulse oximeter should be more than 90%. In my opinion, she should be admitted to a hospital if her oxygen saturation by pulse oximetry is 70 %. Nebulization frequency should be increased to six times a day with Duolin (Levosalbutamol and Ipratropium bromide). Diuretics like Dytor Plus (Torsemide and Spironolactone) 20 mg, one tablet twice a day, should be added to control edema. For pulmonary hypertension, Lupibose (Bosentan) 62.5 mg twice a day should be added to the regimen. Oral steroids may be considered. Consult your specialist doctor, discuss with him or her, and start taking the medicines after their consent.

I hope this helps.

Please feel free to reach out in case of further queries.

Thank you.