Objective: To discuss current therapies for the treatment of chronic obstructive pulmonary disease (COPD) and their efficacy and use according to current treatment guidelines.
Summary: The overall approach to the management of stable COPD is a stepwise increase in treatment, depending on disease severity. Inhaled bronchodilators are the cornerstone of symptomatic management of COPD and include beta 2-agonists, anticholinergics, and methylxanthines. Short-acting beta 2-agonist bronchodilators (e.g., albuterol) have a quick onset of action and are useful for rescue. Long-acting bronchodilators are taken on a regular basis to prevent or reduce symptoms and include beta 2-agonists saleterol and formoterol and anticholinergics ipratropium bromide and tiotropium bromide. Methylxanthines have decreased in usage due to potential toxicity. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines are an international initiative, updated in 2003. GOLD staging consists of 5 levels of severity; treatment guidelines recommend a step-wise approach, with short- and long-acting bronchodilators as the cornerstone of therapy.
Conclusion: Appropriate pharmacologic treatment of symptomatic COPD can result in reduced patient limitations and health care utilization and improved health-related quality of life.