J Korean Med Assoc.  2014 Feb;57(2):155-158.

Recent advance in inhaler medications for chronic obstructive pulmonary disease patients

• Oh YM

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the highest ranking diseases with regard to prevalence and mortality in Korea and also worldwide. In the past decade, effective inhaler medications for COPD treatment have been developed or approved. These inhaler medications have been proven to have beneficial effects on symptoms, lung function, quality of life, exercise capacity, and exacerbation. The inhalers used widely are long-acting anticholinergics, long-acting beta2-agonists, and combined inhalers of a corticosteroid and long-acting beta2-agonist. These inhaler medications are more effective than oral medications and less likely to produce adverse events. However, the inhaler medications should be used appropriately to achieve the desired effect. For COPD patients with a forced expiratory volume in 1 second (FEV1) less than 80% of the predicted value, a long-acting anticholinergic or long-acting beta2-agonist is usually the medication of first choice. If a COPD patient with a FEV1 less than 60% of the predicted value suffers frequent exacerbations, a combined inhaler of corticosteroid and long-acting beta2-agonist is a good choice. To prescribe an inhaler medication for COPD patients, spirometry should be performed, not only to confirm the diagnosis but also to define severity. These effective inhaler medications should be used widely for COPD patients in Korea.

Keyword

Chronic obstructive pulmonary disease; Nebulizers and vaporizers; Cholinergic antagonists; Beta2-agonists; Adrenal cortex hormones

MeSH Terms

Adrenal Cortex Hormones
Cholinergic Antagonists
Diagnosis
Forced Expiratory Volume
Humans
Korea
Lung
Mortality
Nebulizers and Vaporizers*
Prevalence
Pulmonary Disease, Chronic Obstructive*
Quality of Life
Spirometry
Adrenal Cortex Hormones
Cholinergic Antagonists

Figure

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  Figure 1 Pharmacological treatment in chronic obstructive pulmonary disease (COPD) (From Korean Academy of Tuberculosis and Respiratory Diseases. COPD guideline revised 2012 [Internet]. Seoul: Korean Academy of Tuberculosis and Respiratory Diseases; 2012, according to the Creative Commons license [5]. FEV1, forced expiratory volume in 1 second; mMRC, modified Medical Research Council; CAT, assessment test; COPD, chronic obstructive pulmonary disease; LAMA, long-acting muscarinic antagonist; LABA, long-acting beta2-agonist; ICS, inhaled corticosteroid; PED4, phosphodiesterase 4. a) Acute exacerbation of COPD. b) including 24-hour acting LABA (e.g., indacaterol). c) COPD patients having all of the three criteria of FEV1 50% predicted value, chronic bronchitis, and history of exacerbation.

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