J Korean Med Assoc.  2019 May;62(5):277-282. 10.5124/jkma.2019.62.5.277.

Pharmacotherapy for chronic obstructive pulmonary disease

• Jo YS
• Park YB

• KMID: 2445792
• DOI: http://doi.org/10.5124/jkma.2019.62.5.277

Abstract

Appropriate pharmacologic therapy can reduce symptoms and risk and severity of exacerbations, as well as improve the health status and exercise tolerance of patients with chronic obstructive pulmonary disease. The most important medications for treating chronic obstructive pulmonary disease are inhaled bronchodilators including beta2-agonist and anticholinergics. Inhaled corticosteroids as anti-inflammatory drug should be considered in certain patients with caution considering risk and benefit. The choice within each class depends on the availability of medication and the patient's responses and preferences. Each treatment regimen needs to be individualized as the relationship between severity of symptoms, airflow limitation and severity of exacerbation can differ between patients.

Keyword

Pulmonary disease, chronic obstructive; Respiratory therapy

MeSH Terms

Adrenal Cortex Hormones
Bronchodilator Agents
Cholinergic Antagonists
Drug Therapy*
Exercise Tolerance
Humans
Pulmonary Disease, Chronic Obstructive*
Respiratory Therapy
Adrenal Cortex Hormones
Bronchodilator Agents
Cholinergic Antagonists

Figure

• 

  Figure 1 Classification of patients with chronic obstructive pulmonary disease. FEV1, forced expiratory volume in 1 second; mMRC, modified Medical Research Council dyspnea scale; CAT, chronic obstructive pulmonary disease assessment test.

• 

  Figure 2 Pharmacologic treatment algorithms. FEV1, forced expiratory volume in 1 second; AE COPD, acute exacerbation of chronic obstructive pulmonary disease; mMRC, modified Medical Research Council dyspnea scale; CAT, COPD assessment test; SABA, short acting beta2-agonist; LAMA, long acting muscarinic antagonist; LABA, long acting beta2-agonist; ICS, inhaled corticosteroid; PDE4, phosphodiesterase 4. a)Postbronchodilator FEV1 <50%, symptoms of chronic bronchitis, and a history of exacerbations. b)Asthma overlap or high blood eosinophil.

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