[Respiratory medicine in the aged. Therapeutic problemsd].
Chronic obstructive pulmonary disease (COPD) is very common in the elderly, and its treatment needs special concern. Data from two clinical studies (in-patients of an Internal Medicine Department and Nursing-Home, respectively) have been evaluated in order to compare therapeutic approaches to COPD in three separate settings: home, hospital and Nursing-Home. Less than 50% of the overall patients received medical treatment according to the guidelines emerged in the literature. Although cardiovascular problems were highly common in out-patients, their bronchodilator therapy included systemic beta 2-agonists. Theophylline was the main drug prescribed to in-patients discharged from hospital, although inhaling beta 2-agonists were also recommended in few cases. Topical steroids have been widely used. Nursing-Home patients received mostly systemic steroids and few of them had theophylline and inhaling steroids. Anti-cholinergic drugs have never been employed in the overall population of elderly patients. Data concerning medical treatment of infectious respiratory diseases of Nursing-Home patients (both with and without COPD) have also been evaluated. Antimicrobial therapy has been performed according to the special needs of the elderly. During COPD reacutizations, beta 2-agonists and, again, theophylline consumption increased.
Leonardi
R
R
Cattedra di Medicina Interna I, Università di Brescia, I Divisione di Medicina, Azienda Ospedaliera Spedali Civili, Brescia.
Cossi
S
S
De Martinis
M
M
Ghisla
M K
MK
Tomasi
M F
MF
Grassi
V
V
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications; D005100:Expectorants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007297:Inpatients; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000188:drug therapy*; D008297:Male; D009735:Nursing Homes; D010045:Outpatients; D012138:Respiratory Therapy; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy*; D013256:Steroids; D013806:Theophylline / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D005100:Expectorants; D013256:Steroids; D013806:Theophylline
Medicina respiratoria in età geriatrica. Problemi terapeutici.