Dr. Saibal Moitra

Pulmonary diseases are some of the most commonly experienced health conditions all over the world. Millions of people suffer due to various causes including genetics, smoking, pollutants and infection. Now lungs are one of the most important and complex organs of the body. They are the apparatus through which oxygen enters and carbon dioxide gets expelled.

Lungs expand and contract on a constant basis to ensure that we can breathe properly. Let us find out more about lung or pulmonary diseases.

1. Asthma: This is one of the most common and potentially fatal conditions that affect children and adults. It grips the airways formed by the bronchi which branch off into smaller tubes from the main trachea that holds them. This condition causes inflammation, and even spasms, which can lead to wheezing and breathlessness. The main triggers of asthma attacks include allergies, infections and pollutants that may escape into the airways.
2. COPD: This is also known as Chronic Obstructive Pulmonary Disorder. It is an umbrella term used for various lung conditions that cause breathing difficulties due to an obstruction of the airways. Chronic bronchitis is one of the conditions that falls under COPD, and is usually characterised by persistent, hacking coughs.
3. Cystic Fibrosis: This is another condition that affects the airways by causing poor passage of mucus from the bronchial tubes. This condition is a genetic one where the mucus that gathers eventually becomes a lung infection.
4. Pneumonia: This is a condition that causes an infection in the alveoli, which are the tiny tubes that the airways branch into. These are air sacs that can catch myriad infections like pneumonia.
5. Tuberculosis: This is also a kind of pneumonia, which is caused by bacteria called Mycobacterium Tuberculosis. This condition usually attacks the air sacs of the lungs and can be a potentially fatal disease if it is not treated on time. The patient will require immediate hospitalisation.
6. Pulmonary Edema: This condition is caused by fluid leaks from the tiny blood vessels into the surrounding air sacs within the lungs. It can also be caused due to heart failure as well as back pressure which falls on the lungs. Direct injury to the lungs can also lead to this condition.
7. Lung Cancer: This is a fatal disease which can be found in any part of the lungs. It has many forms and the type as well as the location usually determines the kind of treatment option that will be followed.
8. Acute Respiratory Distress Syndrome: When the lungs suffer a sudden injury which is usually caused by a bout of serious illness, it is called ARDS. Treatment involves the use of life support ventilation.

Necessity is the mother of invention. Ironically, accidents to end up in discoveries. Sir Alexander Fleming accidentally discovered Penicillin in 1928. After many years of research and experiments, Penicillin eventually came into use during World War II. Though it’s believed to be a blessing, it has opened the doors for various allergic reactions and bacterial resistance over the period of time. About 10% of people report allergies to Penicillin, wherein more than 90% of these patients are found not to be allergic to Penicillin after skin testing.

Reactions to Penicillin:
Penicillin belongs to a family of antibiotics known as beta-lactams which also comprises of Penicillin G, Cloxacillin, Ampicillin, Amoxicillin, Piperacillin, and many more which are believed to be effective in eradicating common bacterial infections and relatively inexpensive.

The major problem in the use of Penicillin is hypersensitivity reactions. Your immune system can work wonders when encountered with any foreign body (antigen) by producing its antibody, which fights against the antigen. When your body is attacked by bacteria the lymphocytes (T-Cells) trigger the production of antibodies (immunoglobulin) to fight against the bacteria. However, in some people Penicillin administration can be considered as an invader and their immune system produces antibodies against it, thereby resulting in allergic reactions.

Acute and Sub - acute reactions:
You can observe two clinical pictures resulting from penicillin allergy:
Acute allergic reaction:

• Mediated by IgE(Immunoglobulin E) antibodies as a result of previous exposure.
• Arises immediately within minutes to an hour or two.
• Results in release of histamine and other mediators from mast cells.

Sub-Acute allergic reaction:

• Mediated by IgG (Immunoglobulin G) antibodies.
• Occurs 7 to 10 days after Penicillin treatment.
• Results in the activation of the complement reactions producing inflammation.

Risk factors for IgE mediated reaction:

• Frequent or repetitive courses of Penicillin.
• High dose parenteral (rather than oral) administration.
• A history of other allergies, such as food allergy or hay fever.
• Certain illness commonly associated with allergic drug reactions, such as infection with HIV or Epstein - Barr virus.

Watch out for:
While people are taking a Penicillin medication several different rashes can appear:

• Hives:
  • Suggest a true allergy.
  • Raised and intensely itchy spots.
  • Come and go over hours.
  • Occur with other allergic symptoms like wheezing or swelling of the skin or throat.
• Rashes:
  • Typically start after several days of treatment.
  • Flat, blotchy and non-itchy.
  • Spread over days but do not change by the hour.
  • Unlikely to be the result of a dangerous allergy.
• Anaphylaxis:
  • Very rare but life-threatening condition.
  • Causes the widespread dysfunction of the body systems.
• Signs and symptoms of anaphylaxis include:
  • Itching of soft palate
  • Nausea, vomiting
  • Sub sternal pressure
  • Shortness of breath
  • Hypotension
  • Urticaria
  • Laryngeal edema
  • Bronchospasm
  • Cardiac arrhythmias
  • Diarrhea

Other conditions resulting from Penicillin allergy:

• Serum sickness
• Drug induced anemia
• Drug reaction with eosinophilia and systemic symptoms(DRESS)
• Inflammation of the kidneys (nephritis)

In case you have a concern or query you can always consult an expert & get answers to your questions!

COPD stands for Chronic Obstructive Pulmonary Disease and is generally used to describe a broad category of diseases. These include chronic bronchitis, emphysema, non-reversible asthma as well as some forms of bronchiectasis. All of these diseases, however, can be prevented from getting worse by taking similar measures as the causes of these diseases are very similar.

Here are the ways to prevent COPD exacerbations:

1. Cleanliness: It is crucial that you do not allow infections to set in. Infections are probably the worst type of exacerbation possible in COPD. All you need to do to prevent infection is to take a little care to ensure good hygiene. Wash your hands often and do not allow people with colds or flu to come close to you.
2. Take vaccines: Make sure your flu and pneumonia shots have not been missed.
3. Take medicines: It is crucial that medicines for your lungs are taken on schedule, if you have COPD. The possible medicines which you could take if your doctor prescribes it includes inhaled beta-agonists, steroids and anticholinergics.
4. Spirometry: Doctors often recommend the use of the portable Spirometry device, Spirometer, in case of COPD. Spirometers check the condition of the lungs by measuring various parameters to see how well the lungs are working. Spirometers can easily measure FEV1, a parameter which measures how much air can you blow out in one second. This is especially great if you do not know whether your condition has exacerbated or not.
5. Corticosteroid: It is another type of medicine used, which can prevent COPD exacerbations. In its place, even inhaled beta-agonists or anticholinergics can also be used.

In case you have a concern or query you can always consult an expert & get answers to your questions!