title: [The influence of treatment with formoterol, formoterol with tiotropium, formoterol with inhaled glucocorticosteroid and tiotropium on lung functions, tolerance of exercise and simple, morning everyday activities in patients with chronic obstructive pulmonary disease (COPD)].
abstract: Bronchodilators - long-acting b2-adrenergic agonists (formoterol and salmeterol) and a long-acting antimuscarinic drug  (tiotropium), are the main drugs applied in symptomatic treatment of COPD. In patients with COPD, dyspnea is frequently  associated with simple everyday activities. Two questionnaires have been published recently as a means of assessing  the patients' ability to perform morning activities and symptoms. Dynamic hyperinflation is the pathophysiological  disorder responsible for dyspnea and decreased exercise tolerance in COPD. Formoterol is faster than salmeterol in  diminishing air-trapping. It has been shown that treatment with formoterol and tiotropium in COPD patients improves  FEV(1), FVC, IC, symptoms score and quality of life in comparison with tiotropium applied alone. Among LABA and inhaled  glucocorticosteroids combinations, those containing formoterol have a more beneficial effect on the ability to perform  simple morning activities (budesonide/formoterol was better than fluticasone/salmeterol). Beclomethasone/formoterol  - 400/24 mcg/die, in comparison with fluticasone/salmeterol - 500/100 mcg/die significantly reduced air-trapping and  dyspnea in COPD patients. The comparison of budesonide/formoterol - 400/12 mcg 2 x die with beclomethasone/  /formoterol - 200/12 mcg 2 x die has shown similar influence of both combinations on FEV(1), dyspnea, 6-minute walk  test, symptoms score and quality of life. The addition of budesonide and formoterol combination to tiotropium gives  further benefits: reduces number of exacerbations, improves FEV1, symptoms score and performance of simple morning  routines. Doctors should pay more attention to symptoms and limitations in simple activities in the morning and  adequately adjust the treatment.
authors.affiliation: Oddział Kliniczny Chorób Wewnętrznych i Alergologii, Katedra Nauk Klinicznych, Wydział Nauk Biomedycznych i Kształcenia Podyplomowego Uniwersytetu Medycznego w Łodzi. mirszmidt@wp.pl
authors.forename: Mirosław
authors.initials: M
authors.lastname: Szmidt
mesh_terms: D000203:Activities of Daily Living; D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage; D004338:Drug Combinations; D004983:Ethanolamines / Q000008:administration & dosage*; D017079:Exercise Tolerance / Q000187:drug effects*; D000068759:Formoterol Fumarate; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012602:Scopolamine Derivatives / Q000008:administration & dosage*; D000069447:Tiotropium Bromide; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D004338:Drug Combinations; D004983:Ethanolamines; D005938:Glucocorticoids; D012602:Scopolamine Derivatives; D000068759:Formoterol Fumarate; D000069447:Tiotropium Bromide