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Medical Management of Emphysema and Chronic Obstructive Pulmonary Disease

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Abstract

Chronic obstructive pulmonary disease (COPD) is a disease process characterized by the presence of airflow obstruction secondary to emphysema or chronic bronchitis. It is this airflow obstruction that is the main culprit for the various symptoms manisfested by COPD patients. Consequently, one of the main objectives of medical treatment in COPD is to reduce airflow obstruction, which may be accompanied by airway hyperreactivity and, therefore, be partially reversible. Thus, bronchodilators are employed in the treatment of COPD. Furthermore, smoking cessation is the only currently available intervention that may slow progression of this disease. Besides pharmacotherapy, other medical treatments, such as oxygen therapy and pulmonary rehabilitation, have been proven to be beneficial to patients with COPD. Prevention and treatment of infection also plays an important role in reducing the frequency of acute exacerbations in these patients. Emphysema and chronic bronchitis usually coexist to different degrees in COPD patients (1). Pharmacologic treatment of airflow obstruction is less effective in emphysema. This is because airflow limitation as a result of loss of elastic recoil in emphysema is irreversible. Because of the lack of effective medical therapy in severe emphysema, surgical interventions, such as lung volume reduction surgery (LVRS) and lung transplantation, are being explored as alternative treatment options in selected cases. Still, much can be done for most COPD patients by employing appropriate medical management techniques.

Keywords

Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Acute Exacerbation Fluticasone Propionate Airflow Obstruction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media New York 2002

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