[Pharmacologic therapy for patients with stable chronic obstructive pulmonary disease--emphasis on inhaled agents].
One dose of an anticholinergic agents has about the same bronchodilatory effect as one of a beta 2-agonist. Anticholinergic agents may be used first in patients with stable chronic obstructive pulmonary disease, because of the possible adverse effects of beta 2-agonists. One puff of a metered-dose inhaler will not cause a maximal bronchodilatory effect. Both anticholinergic and beta-adrenergic drugs cause dose-dependent bronchodilation when given as aerosols from metered-dose inhalers, and a combination of the two can provide better results. If the response to a single agent is unsatisfactory, use of higher doses is advised and the use of a combination of anticholinergic agents and beta-agonists is recommended. With regard to inhaled corticosteroids, a high dose of inhaled beclomethasone dipropionate (1,500 micrograms per day) can be a effective as oral corticosteroids. Step-by-step pharmacologic therapy with the drugs mentioned above should be used in outpatient management of patients with chronic obstructive pulmonary disease.
Nishimura
K
K
Department of Pulmonary Medicine and Environmental Respiratory Disease, Kyoto University.
Ikeda
A
A
Koyama
H
H
Tsukino
M
M
Hajiro
T
T
Izumi
T
T
D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D018680:Cholinergic Antagonists / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy*; D011788:Quality of Life; D013256:Steroids
D000318:Adrenergic beta-Agonists; D000893:Anti-Inflammatory Agents; D018680:Cholinergic Antagonists; D013256:Steroids