Management of Chronic Obstructive Pulmonary Disease (COPD).
- Author:
Young soo SHIM
1
Author Information
1. Division of Pulmonary and Critical Care Medicine Department of Internal Medicine, Seoul National University College of Medicine, Korea. ysshim@snu.ac.kr
- Publication Type:Review
- Keywords:
Chronic obstructive pulmonary disease;
Treatment
- MeSH:
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
- From:Hanyang Medical Reviews
2005;25(4):53-61
- CountryRepublic of Korea
- Language:Korean
-
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.
