title: Optimizing bronchodilator therapy in emphysema.
abstract: The treatment objectives for chronic obstructive pulmonary disease (COPD) include relieving symptoms such as dyspnea and cough, slowing the accelerated decline in lung function, decreasing exacerbations, and improving quality of life. All major guidelines for COPD management recommend beginning treatment with bronchodilators. There are several classes of bronchodilators, including beta-agonists, anticholinergics, and phosphodiesterase inhibitors, each with a specific mechanism of action. The overall approach to managing stable COPD involves a stepwise increase in treatment. Because of the progressive nature of emphysema, such an approach often involves combining bronchodilators from different pharmacologic classes. This review focuses on the pharmacologic properties of various bronchodilators and on recent studies that have examined combination therapy as a means to optimize treatment.
authors.affiliation: Department of Medicine, The Ohio State University Medical Center, Columbus, OH 43210, USA. philip.diaz@osumc.edu
authors.forename: Philip T
authors.initials: PT
authors.lastname: Diaz
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Bruns
authors.forename: Michael E
authors.initials: ME
authors.lastname: Ezzie
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Marchetti
authors.forename: Byron M
authors.initials: BM
authors.lastname: Thomashow
mesh_terms: D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000494:pharmacology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology*; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000494:pharmacology; D004359:Drug Therapy, Combination; D006801:Humans; D009330:Nebulizers and Vaporizers; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D011656:Pulmonary Emphysema / Q000188:drug therapy*; D013806:Theophylline / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D010726:Phosphodiesterase Inhibitors; D013806:Theophylline