Fast Five Quiz: COPD Key Aspects

Zab Mosenifar, MD

Disclosures

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.

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