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Advisor(s)
Abstract(s)
Esta monografia procura explorar de forma abrangente a Doença Pulmonar Obstrutiva Crónica, focando-se nas suas características fundamentais e no impacto das estratégias terapêuticas para esta doença com morbilidade e mortalidade relevantes. Abrangendo um vasto espetro de tópicos, apresenta-se a epidemiologia, os aspetos clínicos, a etiologia e a patogénese da DPOC, examinando a rede de alterações inflamatórias, o stress oxidativo, a suscetibilidade genética e os factores epigenéticos que contribuem para as alterações estruturais no trato respiratório inferior e para o início e progressão da doença.
Os factores de risco modificáveis, como o tabagismo e as várias formas de poluição atmosférica, são minuciosamente analisados. A revisão também explora a forma como a deficiência de alfa-1-antitripsina, o género, o envelhecimento e as exposições no início da vida acrescentam complexidade à compreensão da suscetibilidade à DPOC, fornecendo uma perspetiva abrangente sobre as diversas origens da doença.
Para além da fisiopatologia, a revisão da literatura analisa as apresentações clínicas, comorbilidades, exacerbações agudas, prognóstico e a ligação entre a DPOC e o cancro do pulmão. É efetuada uma avaliação rigorosa dos métodos de diagnóstico, das abordagens de classificação e das ferramentas de avaliação do estadiamento e da gravidade.
Nas abordagens terapêuticas, são exploradas intervenções não farmacológicas, como estratégias comportamentais, literacia em saúde, vacinação, reabilitação pulmonar e cuidados paliativos. As estratégias farmacológicas, incluindo os fármacos broncodilatadores, os corticosteroides inalados e os inibidores da fosfodiesterase-4, são analisadas no contexto das orientações de tratamento GOLD de 2023. A revisão conclui sublinhando as direções e os desafios futuros, enfatizando a necessidade imperativa de investigação e inovação contínuas na gestão da DPOC. De um modo geral, esta revisão da literatura oferece uma compreensão abrangente da DPOC, servindo como um roteiro para a integração de novas abordagens terapêuticas na prática clínica.
This literature review comprehensively explores Chronic Obstructive Pulmonary Disease, focusing on its fundamental characteristics and the impact on therapeutic strategies for this disease with relevant morbidity and mortality. Covering a wide range of topics, it meticulously studies the epidemiology, clinical aspects, etiology and pathogenesis of COPD, examining the network of inflammatory alterations, oxidative stress, genetic susceptibility and epigenetic factors that contribute to structural alterations in the lower respiratory tract and to the onset and progression of the disease. Modifiable risk factors, such as smoking and various forms of air pollution, are thoroughly analyzed. The review also explores how alpha-1-antitrypsin deficiency, gender, ageing and early life exposures add complexity to the understanding of COPD susceptibility, providing a comprehensive perspective on the diverse origins of the disease. In addition to pathophysiology, the literature review looks at clinical presentations, comorbidities, acute exacerbations, prognosis and the link between COPD and lung cancer. There is a rigorous evaluation of diagnostic methods, classification approaches and tools for assessing staging and severity. In therapeutic approaches, non-pharmacological interventions are explored, such as behavioral strategies, health literacy, vaccination, pulmonary rehabilitation and palliative care. Pharmacological strategies, including bronchodilator drugs, inhaled corticosteroids and phosphodiesterase-4 inhibitors, are analyzed in the context of the 2023 GOLD treatment guidelines. The review concludes by highlighting future directions and challenges, emphasizing the imperative need for continued research and innovation in COPD management. Overall, this literature review provides a comprehensive understanding of COPD, serving as a roadmap for the integration of new therapeutic approaches into clinical practice.
This literature review comprehensively explores Chronic Obstructive Pulmonary Disease, focusing on its fundamental characteristics and the impact on therapeutic strategies for this disease with relevant morbidity and mortality. Covering a wide range of topics, it meticulously studies the epidemiology, clinical aspects, etiology and pathogenesis of COPD, examining the network of inflammatory alterations, oxidative stress, genetic susceptibility and epigenetic factors that contribute to structural alterations in the lower respiratory tract and to the onset and progression of the disease. Modifiable risk factors, such as smoking and various forms of air pollution, are thoroughly analyzed. The review also explores how alpha-1-antitrypsin deficiency, gender, ageing and early life exposures add complexity to the understanding of COPD susceptibility, providing a comprehensive perspective on the diverse origins of the disease. In addition to pathophysiology, the literature review looks at clinical presentations, comorbidities, acute exacerbations, prognosis and the link between COPD and lung cancer. There is a rigorous evaluation of diagnostic methods, classification approaches and tools for assessing staging and severity. In therapeutic approaches, non-pharmacological interventions are explored, such as behavioral strategies, health literacy, vaccination, pulmonary rehabilitation and palliative care. Pharmacological strategies, including bronchodilator drugs, inhaled corticosteroids and phosphodiesterase-4 inhibitors, are analyzed in the context of the 2023 GOLD treatment guidelines. The review concludes by highlighting future directions and challenges, emphasizing the imperative need for continued research and innovation in COPD management. Overall, this literature review provides a comprehensive understanding of COPD, serving as a roadmap for the integration of new therapeutic approaches into clinical practice.
Description
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2023, Universidade de Lisboa, Faculdade de Farmácia.
Keywords
Doença Pulmonar Obstrutiva Crónica (DPOC) Estratégias terapêuticas Alterações inflamatórias Factores epigenéticos Epidemiologia Mestrado Integrado - 2023