Optimizing Treatment of Chronic Obstructive Pulmonary Disease: An Assessment of Current Therapies

Robert A Wise, Donald P. Tashkin

Research output: Contribution to journalArticle

Abstract

Bronchodilators are the mainstay of chronic obstructive pulmonary disease (COPD) therapy. Inhaled short-acting β2-agonists generally have a more rapid onset of effect and shorter duration of action than short-acting anticholinergic agents, and are usually prescribed as "rescue" medication to relieve acute bronchospasm. For patients with persistent symptoms, maintenance therapy with inhaled long-acting β2-agonists is preferable to short-acting β2-agonists because long-acting β2-agonists provide more predictable, longer-lasting improvements in lung function. Long-acting anticholinergic agents can provide similar prolonged improvement in lung function with once-daily dosing. Inhaled corticosteroids reduce the frequency of acute exacerbations and are recommended for patients with severe COPD and frequent exacerbations. Combining different classes of bronchodilators or combining a bronchodilator with a corticosteroid provides greater improvements in lung function and symptoms than the individual agents given alone. Nonpharmacologic interventions, including pulmonary rehabilitation, oxygen therapy, and surgery, can benefit patients at various stages of disease. A treatment algorithm that combines both pharmacologic and nonpharmacologic interventions for the management of COPD is presented.

Original languageEnglish (US)
JournalAmerican Journal of Medicine
Volume120
Issue number8 SUPPL.
DOIs
StatePublished - Aug 2007

Fingerprint

Chronic Obstructive Pulmonary Disease
Bronchodilator Agents
Lung
Cholinergic Antagonists
Adrenal Cortex Hormones
Bronchial Spasm
Therapeutics
Disease Progression
Rehabilitation
Oxygen

Keywords

  • Chronic obstructive pulmonary disease
  • Combination therapy
  • Inhaled bronchodilators
  • Inhaled corticosteroids
  • Oxygen therapy
  • Pulmonary rehabilitation

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Optimizing Treatment of Chronic Obstructive Pulmonary Disease : An Assessment of Current Therapies. / Wise, Robert A; Tashkin, Donald P.

In: American Journal of Medicine, Vol. 120, No. 8 SUPPL., 08.2007.

Research output: Contribution to journalArticle

@article{38469e3222cd43098fbf544a893504ce,
title = "Optimizing Treatment of Chronic Obstructive Pulmonary Disease: An Assessment of Current Therapies",
abstract = "Bronchodilators are the mainstay of chronic obstructive pulmonary disease (COPD) therapy. Inhaled short-acting β2-agonists generally have a more rapid onset of effect and shorter duration of action than short-acting anticholinergic agents, and are usually prescribed as {"}rescue{"} medication to relieve acute bronchospasm. For patients with persistent symptoms, maintenance therapy with inhaled long-acting β2-agonists is preferable to short-acting β2-agonists because long-acting β2-agonists provide more predictable, longer-lasting improvements in lung function. Long-acting anticholinergic agents can provide similar prolonged improvement in lung function with once-daily dosing. Inhaled corticosteroids reduce the frequency of acute exacerbations and are recommended for patients with severe COPD and frequent exacerbations. Combining different classes of bronchodilators or combining a bronchodilator with a corticosteroid provides greater improvements in lung function and symptoms than the individual agents given alone. Nonpharmacologic interventions, including pulmonary rehabilitation, oxygen therapy, and surgery, can benefit patients at various stages of disease. A treatment algorithm that combines both pharmacologic and nonpharmacologic interventions for the management of COPD is presented.",
keywords = "Chronic obstructive pulmonary disease, Combination therapy, Inhaled bronchodilators, Inhaled corticosteroids, Oxygen therapy, Pulmonary rehabilitation",
author = "Wise, {Robert A} and Tashkin, {Donald P.}",
year = "2007",
month = "8",
doi = "10.1016/j.amjmed.2007.04.007",
language = "English (US)",
volume = "120",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier Inc.",
number = "8 SUPPL.",

}

TY - JOUR

T1 - Optimizing Treatment of Chronic Obstructive Pulmonary Disease

T2 - An Assessment of Current Therapies

AU - Wise, Robert A

AU - Tashkin, Donald P.

PY - 2007/8

Y1 - 2007/8

N2 - Bronchodilators are the mainstay of chronic obstructive pulmonary disease (COPD) therapy. Inhaled short-acting β2-agonists generally have a more rapid onset of effect and shorter duration of action than short-acting anticholinergic agents, and are usually prescribed as "rescue" medication to relieve acute bronchospasm. For patients with persistent symptoms, maintenance therapy with inhaled long-acting β2-agonists is preferable to short-acting β2-agonists because long-acting β2-agonists provide more predictable, longer-lasting improvements in lung function. Long-acting anticholinergic agents can provide similar prolonged improvement in lung function with once-daily dosing. Inhaled corticosteroids reduce the frequency of acute exacerbations and are recommended for patients with severe COPD and frequent exacerbations. Combining different classes of bronchodilators or combining a bronchodilator with a corticosteroid provides greater improvements in lung function and symptoms than the individual agents given alone. Nonpharmacologic interventions, including pulmonary rehabilitation, oxygen therapy, and surgery, can benefit patients at various stages of disease. A treatment algorithm that combines both pharmacologic and nonpharmacologic interventions for the management of COPD is presented.

AB - Bronchodilators are the mainstay of chronic obstructive pulmonary disease (COPD) therapy. Inhaled short-acting β2-agonists generally have a more rapid onset of effect and shorter duration of action than short-acting anticholinergic agents, and are usually prescribed as "rescue" medication to relieve acute bronchospasm. For patients with persistent symptoms, maintenance therapy with inhaled long-acting β2-agonists is preferable to short-acting β2-agonists because long-acting β2-agonists provide more predictable, longer-lasting improvements in lung function. Long-acting anticholinergic agents can provide similar prolonged improvement in lung function with once-daily dosing. Inhaled corticosteroids reduce the frequency of acute exacerbations and are recommended for patients with severe COPD and frequent exacerbations. Combining different classes of bronchodilators or combining a bronchodilator with a corticosteroid provides greater improvements in lung function and symptoms than the individual agents given alone. Nonpharmacologic interventions, including pulmonary rehabilitation, oxygen therapy, and surgery, can benefit patients at various stages of disease. A treatment algorithm that combines both pharmacologic and nonpharmacologic interventions for the management of COPD is presented.

KW - Chronic obstructive pulmonary disease

KW - Combination therapy

KW - Inhaled bronchodilators

KW - Inhaled corticosteroids

KW - Oxygen therapy

KW - Pulmonary rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=34547594521&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547594521&partnerID=8YFLogxK

U2 - 10.1016/j.amjmed.2007.04.007

DO - 10.1016/j.amjmed.2007.04.007

M3 - Article

C2 - 17678942

AN - SCOPUS:34547594521

VL - 120

JO - American Journal of Medicine

JF - American Journal of Medicine

SN - 0002-9343

IS - 8 SUPPL.

ER -