title: Respiratory Conditions Update: Chronic Obstructive Pulmonary Disease.
abstract: Chronic obstructive pulmonary disease (COPD) is defined as persistent airflow limitation due to irritant-induced chronic inflammation. A postbronchodilator forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) ratio of 0.7 or less is diagnostic in a patient with dyspnea, chronic cough or sputum production, and a history of irritant exposure. Tobacco smoking is the most significant etiology, and smoking cessation is the only intervention shown to slow disease progression. Long-acting beta2-agonists and long-acting muscarinic antagonists are first-line treatments for patients with persistently symptomatic COPD with an FEV1 of 80% or less of predicted. When COPD is uncontrolled with a long-acting bronchodilator, combination therapy with a long-acting muscarinic antagonist-long-acting beta2-agonist or long-acting beta2-agonist-inhaled corticosteroid should be prescribed. Patients with COPD and reduced exercise tolerance should undergo pulmonary rehabilitation and be evaluated for supplemental oxygen therapy. Other treatment options for persistently symptomatic COPD include inhaler triple therapy (ie, long-acting muscarinic antagonist, long-acting beta2-agonist, inhaled corticosteroid), phosphodiesterase type 4 inhibitors, oxygen, and surgical interventions.
authors: Medical University of South Carolina Montgomery Center for Family Medicine, 155 Academy Ave, Greenwood, SC 29646.
authors: Daphne J
authors: DJ
authors: Karel
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001945:Breathing Exercises; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D018450:Disease Progression; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use; D007251:Influenza, Human / Q000517:prevention & control; D063087:Noninvasive Ventilation; D010102:Oxygen Inhalation Therapy; D010166:Palliative Care; D010567:Pertussis Vaccine / Q000627:therapeutic use; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D011013:Pneumonectomy; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000628:therapy*; D012138:Respiratory Therapy; D016540:Smoking Cessation; D014917:Whooping Cough / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents; D007252:Influenza Vaccines; D010567:Pertussis Vaccine; D022242:Pneumococcal Vaccines