Pharmacologic treatment strategies

Abstract

As COPD is characterized by only partially reversible airway obstruction, respiratory pharmacological agents focus primarily on addressing the airflow limitation, both by bronchodilatation and by reducing airway inflammation. However, the symptoms, morbidity and mortality associated with COPD are also associated with secondary impairments, such as skeletal muscle dysfunction, decreased bone density and alterations of mood. Patient management must also consider common co-morbidities such as cardiovascular disease and diabetes. Therefore pharmacological management must address both the consequences of the pulmonary disease, the secondary impairments and the co-morbidities. This chapter provides discussion of 1) the currently recommended pulmonary pharmacological treatment, 2) the interaction between COPD and cardiovascular disease, and the implications for pharmacological management, 3) an overview of the management of osteoporosis in COPD, 4) the interaction between COPD and diabetes, and the implications for pharmacological management, 5) the management of mood disorders, 6) future treatment directions.