Rangarira ndima iri pasi apa uye ipapo pindura mubvunzo gare gare mumutauro mumwe chetewo sechikamu:  Passage: Mabronchodilators anofemerwa ndiwo mishonga yokutanga inoshandiswa, uye anoguma nebetsero duku. Mhando mbiri huru ndidzo β2 agonists uye anticholinergics; zvose zviripo mumhando refu-inoshanda uye pfupi-inoshanda. Zvinoderedza kunetseka kufema, kuridza mhere-mhere, uye kurovedza muviri, zvichiita kuti upenyu huve nani. Hazvina kujeka kana zvichizochinja kufambira mberi kwechirwere chacho. Kune vaya vane chirwere chisingaremi, mishonga inoshanda kwenguva pfupi inokurudzirwa zvichienderana nezvinodiwa. Muvaya vane chirwere chakakomba zvikuru, mishonga inoshanda kwenguva refu inokurudzirwa. Mishonga inoshanda kwenguva refu inoshanda nokuita kuti hyperinflation ipere. Kana mabronchodilators anoshanda kwenguva refu asina kukwana, ipapo inhaled corticosteroids inowanzowedzerwa. Rudzii rwomushonga unoshanda kwenguva refu, tiotropium (anticholinergic inoshanda kwenguva refu) kana kuti beta agonist inoshanda kwenguva refu (LABA) iri nani haina kujeka, uye kuedza imwe neimwe uye kupfuurira neyo inoshanda zvakanakisisa kungava kunokurudzirwa. Rudzi rwese rwemushonga runoratidzika kuti runoderedza njodzi yekukanganisa kwakanyanya ne15- 25%. Nepo zvose zviri zviviri zvichigona kushandiswa panguva imwe chete, betsero ipi neipi yakawedzerwa inonetsa kukosha kwayo. Vashoma vanoshanda kwenguva pfupi β2 agonists varipo, kubatanidza salbutamol (albuterol) uye terbutaline. Zvinopa zororo rezviratidzo kwemaawa mana kusvika kumatanhatu. LABAs dzakadai sesalmeterol, formoterol, uye indacaterol dzinowanzoshandiswa senzira yokurapa yokuchengetedza. Vamwe vanofunga kuti uchapupu hwekubatsira hune mashoma, nepo vamwe vachiona uchapupu hwekubatsira hwakagadzwa. Kushandiswa kwenguva refu kunoratidzika kuva kwakachengeteka muCOPD nemigumisiro yakaipa inosanganisira kudedera uye kurova kwemoyo. Apo anoshandiswa ne inhaled steroids anowedzera ngozi yepneumonia. Nepo steroid neLABAs dzingashanda zviri nani pamwe chete, hazvina kujeka kana betsero duku iyi ichipfuura ngozi dzakawedzera. Pane humwe uchapupu hwokuti kurapwa pamwe chete kweLABAs neLAMA (long-acting muscarinic antagonists), anticholinergic, kunogona kukonzera kuderera kwezvirwere, kuderera kwepneumonia, kuvandudzwa kwehuwandu hwekufema kwakamanikidzwa (FEV1%), uye zvinogona kuvandudza mararamiro kana zvichienzaniswa nekurapwa neLABA uye...  Mubvunzo: Zvinodzvinyirira zvinoshanda kwenguva yakareba sei?
maawa mana kusvika kumatanhatu