Abramson, M.Crockett, A.Frith, P.McDonald, C.2007-01-152007-01-152006Medical Journal of Australia, 2006; 184(7):342-3450025-729X1326-5377http://hdl.handle.net/2440/22745The document attached has been archived with permission from the editor of the Medical Journal of Australia.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.• 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.enHumansAsthmaPulmonary Disease, Chronic ObstructiveScopolamine DerivativesAdrenergic beta-AgonistsBronchodilator AgentsExpectorantsDrug CombinationsGlucocorticoidsDiagnosis, DifferentialRespiratory Function TestsVaccinationAdministration, InhalationAdministration, OralRisk FactorsEvidence-Based MedicineSocial SupportAustraliaPractice Guidelines as TopicTiotropium BromideJournal article002006054710.5694/j.1326-5377.2006.tb00268.x0002376013000092-s2.0-3364577859252914