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Self-Assessment Questions

Pulmonary Disease

Answer 4
  1. Add an inhaled corticosteroid. Regular treatment with inhaled corticosteroids has been shown to reduce the frequency of exacerbations and improve health status in symptomatic COPD patients with an FEV1 < 50% predicted and repeated exacerbations (eg, 3 or more in the last 3 years). Long-term treatment with oral corticosteroids is not recommended in COPD.2 Theophylline is effective in COPD but is not a preferred drug due to its potential toxicity. There is no evidence that theophylline reduces the frequency of exacerbation. Long-term oxygen therapy is indicated for patients with very severe COPD who have a Pao2 at or below 55 mm Hg or Sao2 at or below 88%, or, if there is evidence of cor pulmonale or polycythemia (hematocrit > 55%), Pao2 between 55 and 60 mm Hg or Sao2 of 89%.

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