| Medications for COPD: a review of effectiveness. | |
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MedLine Citation:
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PMID: 17990836 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Chronic obstructive pulmonary disease (COPD) is a common problem among patients presenting to primary care. This condition has multiple individual and combined treatment regimens. The goals of treatment are to improve quality of life, exercise tolerance, sleep quality, and survival; and to reduce dyspnea, nocturnal symptoms, exacerbations, use of rescue medications, and hospitalizations. All patients benefit from bronchodilator medications as needed. Long-acting inhaled anticholinergics are probably more beneficial than short-acting formulations. Use of inhaled corticosteroids might benefit patients with mild COPD who have an inflammatory component or significant reversibility on spirometry. Patients with moderate to severe disease benefit from the use of long-acting inhaled anticholinergics, inhaled corticosteroids, and possibly a long-acting beta2 agonist or mucolytics. For rescue therapy, short-acting beta2 agonists or combination anticholinergics with a short-acting beta2 agonist should be used. Inhaled corticosteroids should be considered before initiating a long-acting beta2 agonist. Caution should be used if a long-acting beta2 agonist is discontinued before initiation of an inhaled corticosteroid because this may precipitate exacerbations. Evidence to support the use of mucolytics, oral theophylline, and oral corticosteroids is limited. Patients with severe hypoxemia (i.e., arterial oxygen pressure less than 55 mm Hg or oxygen saturation less than 88 percent) should be given continuous oxygen. |
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Authors:
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Gil C Grimes; John L Manning; Parita Patel; R Marc Via |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: American family physician Volume: 76 ISSN: 0002-838X ISO Abbreviation: Am Fam Physician Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-11-09 Completed Date: 2007-12-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1272646 Medline TA: Am Fam Physician Country: United States |
Other Details:
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Languages: eng Pagination: 1141-8 Citation Subset: AIM; IM |
Affiliation:
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Texas A&M University Health Science Center, Temple, Texas, USA. gilgrimes@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Agonists
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therapeutic use Bronchodilator Agents / therapeutic use Cholinergic Antagonists / therapeutic use Expectorants / therapeutic use Glucocorticoids / therapeutic use Humans Pulmonary Disease, Chronic Obstructive / drug therapy* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Agonists; 0/Bronchodilator Agents; 0/Cholinergic Antagonists; 0/Expectorants; 0/Glucocorticoids |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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