Treatment of mild chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is an epidemic in many parts of the world. Most patients with COPD demonstrate mild disease. The cornerstone of management of mild disease is smoking cessation, which is the only proven intervention to relieve symptoms, modify its natural history and reduce mortality. For asymptomatic patients, it is the only required therapy. Short-acting bronchodilators can be added on an as needed basis for those with intermittent symptoms and regularly for those with persistent symptoms. Long-acting bronchodilators can be substituted for those who remain symptomatic despite regular use of short-acting bronchodilators. Inhaled corticosteroids do not modify the natural history of COPD and as such cannot be recommended as standalone therapy for mild COPD. However, for patients with refractory and intractable symptoms, they may be used in combination with long-acting beta-2 agonists. Influenza and pneumococcal vaccination and pulmonary rehabilitation are other therapies that may be considered for select patients with mild disease. In this paper, we summarize the current standard of care for patients with mild COPD.
Chee
Alex
A
Department of Medicine, Division of Respirology, The University of British Columbia and Providence Heart and Lung Institute and The James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St Paul's Hospital, Vancouver, BC, Canada.
Sin
Don D
DD
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018450:Disease Progression; D015444:Exercise; D006801:Humans; D007252:Influenza Vaccines; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality; D022242:Pneumococcal Vaccines; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012720:Severity of Illness Index; D016540:Smoking Cessation; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000319:Adrenergic beta-Antagonists; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines