Hanyang Med Rev.  2005 Nov;25(4):53-61.

Management of Chronic Obstructive Pulmonary Disease (COPD)

• Shim YS

Abstract

Chronic obstructive pulmonary disease(COPD) is a major cause of chronic morbidity and mortality. To improve management and prevention through a concerted worldwide effort, the NIH and the WHO created the Global Initiative for Obstructive Pulmonary Disease (GOLD) and published management guideline. The guideline consists of 4 components; assessment and monitoring, avoidance of risk factors; management of stable COPD and management of exacerbation. Spirometry is essential for the diagnosis and for monitoring disease progression. Smoking cessation can reduce symptoms and prevent progression of disease. Bronchodilator therapy is the mainstay of COPD treatment. beta2-agonists, anticholinergics, and theophylline are available bronchodilators and can be used individually or in combination. Inhaled corticosteroids can also improve symptom and can be combined with bronchodilators. Inhaled corticosteroids, in addition, might reduce exacerbation frequency and severity. Non-pharmacotherapies such as rehabilitation programs and long term oxygen therapy can improve the quality of life and the survival in many patients. Stepwise increment of treatment according to the severity is recommended for stable COPD. The mainstay of treatment for acute exacerbation involves increasing bronchodilator therapy, systemic use of corticosteroids, and antibiotic therapy. In those with respiratory failure, non-invasive ventilation has been shown to reduce intubation rates, shorten lengths of hospitalization, and improve mortality.

Keyword

Chronic obstructive pulmonary disease; Treatment

MeSH Terms

Adrenal Cortex Hormones
Bronchodilator Agents
Cholinergic Antagonists
Diagnosis
Disease Progression
Hospitalization
Humans
Intubation
Lung Diseases, Obstructive
Mortality
Noninvasive Ventilation
Oxygen
Pulmonary Disease, Chronic Obstructive*
Quality of Life
Rehabilitation
Respiratory Insufficiency
Risk Factors
Smoking Cessation
Spirometry
Theophylline
Adrenal Cortex Hormones
Bronchodilator Agents
Cholinergic Antagonists
Oxygen
Theophylline