COPD is commonly associated with progressive hypoxemia. Oral and inhaled medications are used for patients with stable disease to reduce dyspnea and improve exercise tolerance, but they do not target 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. 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.
Most of the oral and inhaled medications used for COPD 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.
Pulmonary rehabilitation has been shown to improve activity levels in patients with COPD and may improve functional capabilities more than would an inhaler alone.
For more information about pharmacologic treatment of COPD, read here.
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Cite this: Fast Five Quiz: Can You Properly Identify and Treat COPD? - Medscape - May 27, 2020.
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