The goals of pharmacologic management of COPD are to enhance smoking cessation, alleviate
dyspnea by promoting bronchodilatation, treating exacerbations, and preserving lung
function. The step approach to the use of bronchodilators based upon the degree of
dyspnea is reviewed with particular attention to anticholinergic agents and beta agonists.
Bronchodilators are useful not only to improve lung function but also to enhance health-related
quality of life. Although inhaled steroids may prevent decline in lung function and
reduce the number of exacerbations, their precise role awaits completion of further
studies currently in progress. Exacerbations should be treated with antibiotics, and
the choice of agents depends upon the severity of the underlying lung disease.
Anticholinergic bronchodilators - beta agonist bronchodilators - antibiotics - acute
exacerbations of chronic bronchitis - corticosteroids
