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Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Author(s) -
Adkison Julie D.,
Konzem Sherri L.
Publication year - 2001
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.21.11.929.34523
Subject(s) - medicine , intensive care medicine , antibiotics , pulmonary disease , sputum , ipratropium bromide , regimen , copd , bronchodilator , asthma , tuberculosis , pathology , microbiology and biotechnology , biology
Patients with chronic obstructive pulmonary disease are at high risk for acute exacerbations. Strategies that may prevent exacerbations are smoking cessation, pulmonary rehabilitation, and influenza vaccination. Therapy includes bronchodilators, corticosteroids, and antibiotics. Rapid‐acting β 2 ‐agonists are bronchodilating agents of choice. Ipratropium should be considered in patients who fail or cannot tolerate β 2 ‐agonists. Data do not support combining anticholinergics and β 2 ‐agonists in acute exacerbations; however, new data do support systemic corticosteroids for their role in reducing airway inflammation. Antibiotics should be included in the regimen if two of the three following are present: increased dyspnea, increased sputum volume, and increased sputum purulence. Many exacerbations may be caused by viruses or noninfective sources, in which case antibiotics are not indicated. Oxygen administration with or without assisted ventilation may be required for short‐term management.