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[Practice guideline 'Medical treatment of COPD'].
Ned Tijdschr Geneeskd. 2008 Jun 28; 152(26):1465-8.NT

Abstract

The practice guideline 'Medical treatment of COPD' completes the practice guideline for diagnostics and non-medicinal treatment. Patients with stable chronic obstructive pulmonary disease (COPD) and minor complaints can be treated with short-acting beta-2-adrenoceptor agonists or anticholinergics or a combination of these. In cases of insufficient clinical control of the condition or if patients use their medication for maintenance, a long-acting bronchodilator is the drug of choice. In patients with severe or very severe COPD (stage III-IV of the criteria of the Global Initiative for Obstructive Lung Disease (GOLD) or with cardiac comorbidity, there is a slight preference for the long-acting anticholinergic tiotropium. Inhaled corticosteroids (ICS) reduce the exacerbation frequency in patients with moderate to severe or very severe COPD (GOLD stage II-IV) and recurrent exacerbations. A combination of ICS with long-acting beta-2-adrenoceptor agonists (LABA) is prescribed in patients with GOLD stage III-IV with at least 2 exacerbations in the past year, a deterioration of the quality of life and with symptoms, if treatment with a LABA alone or an ICS alone results in insufficient improvement. Anticholinergics and beta-2-adrenoceptor agonists have a similar effect on bronchodilation in patients with an acute exacerbation of COPD. If improvement is inadequate, patients with an exacerbation should be treated with prednisolone 30 mg for a period of 7 to 14 days. In outpatients and clinical patients with an exacerbation ofCOPD, an antibiotic is added to prednisolone in very poor lung function (forced expiratory volume in 1 second (FEV1) < 30%) or another risk factor of a severe disease course, such as a respiratory rate > or = 30/min, a systolic blood pressure < 90 mmHg, and disorientation in time, place or person.

Authors+Show Affiliations

Universitair Medisch Centrum St Radboud, afd. Longziekten, 454, Postbus 9101, 6500 HB Nijmegen. r.dekhuijzen@long.umcn.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

dut

PubMed ID

18666664

Citation

Dekhuijzen, P N R., et al. "[Practice Guideline 'Medical Treatment of COPD']." Nederlands Tijdschrift Voor Geneeskunde, vol. 152, no. 26, 2008, pp. 1465-8.
Dekhuijzen PN, Broeders ME, Tuut MK, et al. [Practice guideline 'Medical treatment of COPD']. Ned Tijdschr Geneeskd. 2008;152(26):1465-8.
Dekhuijzen, P. N., Broeders, M. E., Tuut, M. K., & Grol, M. H. (2008). [Practice guideline 'Medical treatment of COPD']. Nederlands Tijdschrift Voor Geneeskunde, 152(26), 1465-8.
Dekhuijzen PN, et al. [Practice Guideline 'Medical Treatment of COPD']. Ned Tijdschr Geneeskd. 2008 Jun 28;152(26):1465-8. PubMed PMID: 18666664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Practice guideline 'Medical treatment of COPD']. AU - Dekhuijzen,P N R, AU - Broeders,M E A C, AU - Tuut,M K, AU - Grol,M H, PY - 2008/8/1/pubmed PY - 2008/9/3/medline PY - 2008/8/1/entrez SP - 1465 EP - 8 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 152 IS - 26 N2 - The practice guideline 'Medical treatment of COPD' completes the practice guideline for diagnostics and non-medicinal treatment. Patients with stable chronic obstructive pulmonary disease (COPD) and minor complaints can be treated with short-acting beta-2-adrenoceptor agonists or anticholinergics or a combination of these. In cases of insufficient clinical control of the condition or if patients use their medication for maintenance, a long-acting bronchodilator is the drug of choice. In patients with severe or very severe COPD (stage III-IV of the criteria of the Global Initiative for Obstructive Lung Disease (GOLD) or with cardiac comorbidity, there is a slight preference for the long-acting anticholinergic tiotropium. Inhaled corticosteroids (ICS) reduce the exacerbation frequency in patients with moderate to severe or very severe COPD (GOLD stage II-IV) and recurrent exacerbations. A combination of ICS with long-acting beta-2-adrenoceptor agonists (LABA) is prescribed in patients with GOLD stage III-IV with at least 2 exacerbations in the past year, a deterioration of the quality of life and with symptoms, if treatment with a LABA alone or an ICS alone results in insufficient improvement. Anticholinergics and beta-2-adrenoceptor agonists have a similar effect on bronchodilation in patients with an acute exacerbation of COPD. If improvement is inadequate, patients with an exacerbation should be treated with prednisolone 30 mg for a period of 7 to 14 days. In outpatients and clinical patients with an exacerbation ofCOPD, an antibiotic is added to prednisolone in very poor lung function (forced expiratory volume in 1 second (FEV1) < 30%) or another risk factor of a severe disease course, such as a respiratory rate > or = 30/min, a systolic blood pressure < 90 mmHg, and disorientation in time, place or person. SN - 0028-2162 UR - https://www.unboundmedicine.com/medline/citation/18666664/[Practice_guideline_'Medical_treatment_of_COPD']_ L2 - https://medlineplus.gov/copd.html DB - PRIME DP - Unbound Medicine ER -