Medications for COPD : a review of effectiveness

Chronic obstructive pulmonary disease (COPD) is a common problem among patients presenting to primary care. This condition has multiple individual and combined treatment regimens. The goals of treatment are to improve quality of life, exercise tolerance, sleep quality, and survival; and to reduce dyspnea, nocturnal symptoms, exacerbations, use of rescue medications, and hospitalizations. All patients benefit from bronchodilator medications as needed. Long-acting inhaled anticholinergics are probably more beneficial than short-acting formulations. Use of inhaled corticosteroids might benefit patients with mild COPD who have an inflammatory component or significant reversibility on spirometry. Patients with moderate to severe disease benefit from the use of long-acting inhaled anticholinergics, inhaled corticosteroids, and possibly a long-acting beta2 agonist or mucolytics. For rescue therapy, short-acting beta2 agonists or combination anticholinergics with a short-acting beta2 agonist should be used. Inhaled corticosteroids should be considered before initiating a long-acting beta2 agonist. Caution should be used if a long-acting beta2 agonist is discontinued before initiation of an inhaled corticosteroid because this may precipitate exacerbations. Evidence to support the use of mucolytics, oral theophylline, and oral corticosteroids is limited. Patients with severe hypoxemia (i.e., arterial oxygen pressure less than 55 mm Hg or oxygen saturation less than 88 percent) should be given continuous oxygen.

Medienart:

Artikel

Erscheinungsjahr:

2007

Erschienen:

2007

Enthalten in:

Zur Gesamtaufnahme - volume:76

Enthalten in:

American family physician - 76(2007), 8 vom: 15. Okt., Seite 1141-8

Sprache:

Englisch

Beteiligte Personen:

Grimes, Gil C [VerfasserIn]
Manning, John L [VerfasserIn]
Patel, Parita [VerfasserIn]
Via, R Marc [VerfasserIn]

Themen:

Adrenergic beta-Agonists
Bronchodilator Agents
Cholinergic Antagonists
Expectorants
Glucocorticoids
Journal Article
Review

Anmerkungen:

Date Completed 14.12.2007

Date Revised 09.11.2007

published: Print

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM174903197