Chronic obstructive pulmonary disease: all things inhaled and more

The burden of chronic obstructive pulmonary disease (COPD) is well documented along with the impact at the societal and personal level.^1,2 It is caused by noxious substances and /or gases entering the lungs. This leads to abnormalities in the small airways of the lungs limiting airflow in and out of the lungs due to a combination of small airways disease (obstructive bronchiolitis) and destruction of the lung parenchyma (emphysema). This leads in turn to the well-recognised symptoms of COPD dyspnoea, cough, regular sputum production and wheeze, although these vary between individuals.¹ These symptoms are chronic and progressive so early intervention is important and guidelines remind us that COPD is both preventable and treatable.¹