Journal List > J Korean Med Assoc > v.61(9) > 1101041

Kim, Park, and Yoo: Pharmacotherapy for chronic obstructive pulmonary disease

Abstract

The goals of management of stable chronic obstructive pulmonary disease (COPD) are to reduce both current symptoms and future risks with minimal side effects from treatment. Identification and reduction of exposure to risk factors are important in the treatment and prevention of COPD. Appropriate pharmacologic therapy can reduce symptoms and exacerbations, and improve health status and exercise tolerance. To date, none of the existing medications for COPD has been shown to modify disease progression or reduce mortality. The classes of medication are bronchodilators including beta2-agonist, anticholinergics and anti-inflammatory drug including inhaled corticosteroid and phosphodiesterase-4 inhibitor such as roflumilast. Each treatment regimen needs to be individualized as the relationship between severity of symptoms, airflow limitation and severity of exacerbation can differ between patients.

Figures and Tables

Figure 1

Classification of patients with chronic obstructive pulmonary disease. FEV1, forced expiratory volume in 1 second; mMRC, modified Medical Research Council dyspnea score; CAT, COPD Assessment Test score.

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Figure 2

Pharmacologic treatment algorithms. FEV1, forced expiratory volume in one second; mMRC, modified Medical Research Council dyspnea score; CAT, COPD Assessment Test score; AE COPD, acute exacerbation of chronic obstructive pulmonary disease; SABA, short acting bronchodilator; LABA, long acting bronchodilator; LAMA, long acting muscarinic antagonist; ICS, inhaled corticosteroid; PDE4, phosphodiesterase-4. a)Postbronchodilator FEV1 <50%, symptoms of chronic bronchitis, and a history of exacerbations. b)Asthma overlap or high blood eosinophil.

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Table 1

Available inhaled bronchodilators in Korea (2018)

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SABA, short acting bronchodilator; LABA, long acting bronchodilator; SAMA, short acting muscarinic antagonist; LAMA, long acting muscarinic antagonist; MDI, metered dose inhaler; DPI, dry powder inhaler.

Table 2

Insurance standard of inhaled bronchodilators and inhaled steroids in Korea

jkma-61-545-i002

LAMA, long acting muscarinic antagonist; LABA, long acting bronchodilator; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in one second.

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TOOLS
ORCID iDs

In Ae Kim
https://orcid.org/0000-0002-8994-2891

Yong Bum Park
https://orcid.org/0000-0002-5814-6104

Kwang Ha Yoo
https://orcid.org/0000-0001-9969-2657

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