Fast Five Quiz: COPD Key Aspects

Zab Mosenifar, MD


August 10, 2020

According to the 2020 GOLD guidelines, prevention and maintenance therapy recommendations are as follows:

  • Smoking cessation is key. Pharmacotherapy and nicotine replacement increase long-term smoking abstinence rates, as do legislative bans on smoking. The effectiveness and safety of e-cigarettes as a smoking cessation aid are uncertain.

  • Pharmacologic therapy can reduce the symptoms of COPD, reduce the severity and frequency of exacerbations, and improve exercise tolerance and health status.

  • Pharmacologic treatment regimens should be individualized. They should be guided by symptom severity; exacerbation risk; adverse effects; comorbidities; drug availability and cost; and patient response, preference, and ability to utilize the various drug delivery devices.

  • Inhaler technique should be assessed regularly.

  • Pneumococcal and influenza vaccinations decrease the incidence of lower respiratory tract infections.

  • Pulmonary rehabilitation improves symptoms, physical and emotional participation in everyday activities, and quality of life.

  • Patients with severe resting chronic hypoxemia have improved survival with long-term oxygen therapy.

  • In patients with stable COPD and resting or exercise-induced moderate desaturation, routine long-term oxygen treatment is not recommended; however, consider individual patient factors regarding the need for supplemental oxygen.

  • In patients with stable COPD, combinations of short-acting beta2-agonists and short-acting antimuscarinics are superior to either type of medication alone improving FEV1 and symptoms.

  • Long-acting antimuscarinics have a greater effect on exacerbation rates compared with long-acting beta2-agonists.

  • In patients with severe chronic hypercapnia and a history of hospitalization for acute respiratory failure, long-term noninvasive ventilation may prevent rehospitalization and decrease mortality.

  • Selected patients with advanced emphysema refractory to optimized medical care may benefit from surgical or bronchoscopic interventional treatments.

  • In advanced COPD, palliative approaches are effective in controlling symptoms.

Read more guidelines for COPD management.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.