Oral and inhaled medications are used for patients with stable disease to reduce dyspnea and improve exercise tolerance. Most of the medications used are directed at the following four potentially reversible causes of airflow limitation in a disease state that has largely fixed obstruction:
Bronchial smooth muscle contraction;
Bronchial mucosal congestion and edema;
Airway inflammation; and
Increased airway secretions.
COPD is commonly associated with progressive hypoxemia. Oxygen administration reduces mortality rates in patients with advanced COPD because of the favorable effects on pulmonary hemodynamics. Long-term oxygen therapy improves survival twofold or more in hypoxemic patients with COPD. Hypoxemia is defined as PaO2 (partial pressure of oxygen in arterial blood) of < 55 mm Hg or oxygen saturation of < 90%. Oxygen was used for 15-19 hours per day. Therefore, specialists recommend long-term oxygen therapy for patients with a PaO2 of < 55 mm Hg, a PaO2 of < 59 mm Hg with evidence of polycythemia, or cor pulmonale. Reevaluate these patients one to three months after initiating therapy, because some patients may not require long-term oxygen.
For more information about pharmacologic treatment of COPD, read here.
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