COPDX: an update of guidelines for the management obstructive pulmonary disease with a review of recent evidence
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(Published version)
Date
2006
Authors
Abramson, M.
Crockett, A.
Frith, P.
McDonald, C.
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Journal article
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Medical Journal of Australia, 2006; 184(7):342-345
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Michael J Abramson, Alan J Crockett, Peter A Frith and Christine F McDonald
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Abstract
• Long-acting β2 agonists are an effective and convenient treatment for chronic obstructive pulmonary disease (COPD), but do not significantly improve lung function. • The long-acting anticholinergic tiotropium, which can be taken once daily, decreases exertional dyspnoea and increases endurance by reducing hyperinflation. • The role in COPD of the combination of a long-acting β2 agonist and a glucocorticoid in a single inhaler remains unclear. • The minimum duration of an effective pulmonary rehabilitation program that includes exercise training is 6 weeks. • Long-term treatment with inhaled glucocorticoids may reduce the rate of decline in lung function, but the effect is small. • Aminophylline should no longer be routinely used in acute exacerbations of COPD. • Non-invasive positive pressure ventilation (NPPV) reduces mortality and hospital stay in patients with acute hypercapnic ventilatory failure; it is also an effective weaning strategy for patients who require intubation. • Further studies are required to clarify the role of NPPV in the long-term management of stable COPD.
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The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.