8.0 Respiratory System

Respiratory System Introduction

Every year, Canadians visit their health care provider for respiratory diseases such as allergies, asthma, bronchitis, common cold, chronic obstructive pulmonary disease (COPD), and pneumonia. Respiratory diseases and illnesses are a major public health concern in Canada.

Respiratory illnesses such as the common cold are the most frequently reported, and are attributed to over 100 rhinoviruses. It is usually self-limiting and can be treated with many OTC remedies to suppress cough (antitussives), to use as a decongestant or to suppress nasal inflammation (antihistamines, intranasal glucocorticoids). Note that these remedies only manage the symptoms rather than treat the underlying viral infection.

Chronic respiratory diseases (CRD) are an umbrella term to describe diseases that effect the airways and other structures of the lungs. Some of the most common are chronic obstructive pulmonary disease (COPD), asthma, occupational lung diseases and pulmonary hypertension (World Health Organization, 2026). Other respiratory conditions that have a significant and potentially debilitating affect are cystic fibrosis, pneumonia, bronchiolitis, tuberculosis, and lung cancer. Respiratory diseases affect people of all ages and many are chronic, thereby having a major impact not only on the individual with the disease, but on their family, community and the health care system (Public Health Agency of Canada, 2018). Over 3 million Canadians are affected by one of the five major respiratory diseases, COPD, asthma, tuberculosis, lung cancer and cystic fibrosis, with many more persons impacted by other diseases not tracked by the health care system (Public Health Agency of Canada, 2018).

The cost of chronic respiratory diseases has a great impact on health care costs in Canada.  Currently, 3 million people in Canada, about 9.5% of Canada’s population, have asthma. Interestingly, 2 million adults have been diagnosed with COPD, and approximately 1.5 million people have not yet been diagnosed. The burden of respiratory diseases affects individuals and their families, schools, workplaces, neighborhoods, and cities.  Improving health surveillance efforts will help to support and design new policies and programs that will positively impact the effects of these diseases on Canadians. The Canadian Chronic Disease Surveillance System (CCDSS) researches and identifies data on chronic diseases such as asthma and COPD to seek further solutions for the improvement of health for diagnosed Canadians (Public Health Agency of Canada, 2018).

The biggest risk factor for many of the chronic conditions is tobacco smoke (Public Health Agency of Canada, 2018). In addition, other risk factors include air pollution, occupational chemicals and dusts, and frequent lower respiratory infections during childhood. CRDs are not curable; however, various forms of treatment that help open the air passages and improve shortness of breath can help control symptoms and improve daily life for people living with these conditions.

There are a variety of treatments for acute exacerbation and chronic respiratory conditions that often include inhalers that either open the airways (bronchodilators) or reduce inflammation (ie. glucocorticoids).  In this unit, we will learn about some of the more common drug classifications, recognizing there are other treatments that are often used in combination therapies.

As you transition through this chapter and begin the section on medications to treat, you will notice that multiple medication classifications are discussed but there is only one medication card to be completed per chapter. These medication cards were developed as a guide for you to use in your own practice. There is a section that provides these tools in a word format for you to download and edit as needed. But before we look at the medications, let’s review the anatomy and physiology.

References:

Public Health Agency of Canada. (2018). Asthma and chronic obstructive pulmonary disease (COPD) in Canada, 2018. Government of Canada. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/asthma-chronic-obstructive-pulmonary-disease-canada-2018.html

World Health Organization (2026). Chronic respiratory diseases. Chronic respiratory diseases