Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Interactive:
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Quiz
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Exams
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Pulmonary Disease


Answer 2
  1. A short-acting bronchodilator as needed and regular treatment with a long-acting bronchodilator. This patient has moderate COPD (FEV1/FVC < 70%; 50% of predicted ≤ FEV1 < 80% of predicted) according to the revised GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines.2 The GOLD guidelines suggest regular treatment with a long-acting bronchodilator, such as salmeterol or formoterol, plus a short-acting bronchodilator as rescue medication in this category. Inhaled corticosteroids are indicated in symptomatic COPD patients with severe COPD (FEV1 < 50% of predicted) and repeated exacerbations (eg, 3 or more in the past 3 years). A short-acting bronchodilator can be used on an as-needed basis in mild COPD (FEV1 > 80 % of predicted) if patients are symptomatic.

    REFERENCES
    1. Anthonisen NR, Connett JE, Kiley JP, et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. JAMA 1994;272:1497-505.
    2. GOLD executive summary (updated 2003). Available at www.goldcopd.com/es.html. Accessed 21 Apr 2004.
    3. Niewoehner DE, Erbland ML, Deupree RH, et al. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. Department of Veterans Affairs Cooperative Study Group. N Engl J Med 1999; 340:1941-7.

Click here to return to the questions

 

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj