アレルギーと治療のジャーナル

概要

Management of Chronic Obstructive Pulmonary Disease

Vishal Sekhri, Wilbert S. Aronow and Dipak Chandy

Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity throughout the world. It is the only cause of death among the top ten causes that is increasing and is expected to become the third leading cause of death in the world by 2020. A diagnosis of COPD should be considered in any patient with a history of exposure to risk factors for the disease and/or the presence of chronic cough, sputum production or dyspnea. Patients with COPD are categorized into 5 stages based on their pulmonary function tests and symptoms. Smoking cessation is the single most effective way to stop the progression of COPD and prolong life. Pharmacologic management of stable COPD includes the use of bronchodilators (β-2 agonists, anticholinergics and methylxanthines) and inhaled corticosteroids. Other adjunctive measures include vaccination, oxygen therapy, pulmonary rehabilitation and certain surgical measures like bullectomy and lung transplantation. Management of acute exacerbations includes the use of systemic steroids, antibiotics, bronchodilators and oxygen therapy. During very severe exacerbations, patients may need ventilatory support.