Journal List > J Korean Med Assoc > v.49(4) > 1080630

Kim: Pharmacotherapy in Stable Chronic Obstructive Pulmonary Disease

Abstract

The general approach to manage stable COPD is characterized by a stepwise increase in treatment, depending on the severity of the disease. None of the existing medications for COPD have been shown to modify the long-term decline in lung function that is the hallmark of the disease. Therefore, pharmacotherapy in COPD is used to decrease symptoms and/or complications. Bronchodilator medications are central to the symptomatic management of COPD. They are given on an as-needed basis or on a regular basis to prevent or reduce symptoms. The principal bronchodilator treatments are β2-agonists, anticholinergics, theophylline, and a combination of these drugs. Regular treatment with long-acting bronchodilators is more effective and convenient than treatment with short-acting bronchodilators, but more expensive. The addition of regular treatment with inhaled steroids to bronchodilator treatment is appropriate for symptomatic COPD patients with an FEV1<50% predicted (Stage III: Severe COPD and Stage IV: Very Severe COPD) or repeated exacerbations (for example, more than 3 times during the last 3 years). Chronic treatment with systemic steroids should be avoided, if possible.

Figures and Tables

Table 1
Commonly used formulations of drugs in COPD in Korea
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MDI=Metered Dose Inhaler; DPI=Dry Powder Inhaler

Table 2
Factors that affect theophylline metabolism in COPD
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Table 3
Therapy at each stage of COPD
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