Drug therapy

Short-acting β2 agonists are the cornerstone of drug therapy for acute exacerbations. The most widely used drug is Ventolin®. In life-threatening exacerbations, β2 agonists may be given continuously via a nebulizer until improvement occurs.

Oral corticosteroids should begin immediately for all but mild exacerbations. Oral prednisolone is recommended at a dose of 30–40mg per day for 10–14 days. Inhaled corticosteroids have no role in the treatment of acute exacerbations.

Antibiotics are recommended for exacerbations in patients who either:

  • have the three cardinal symptoms – increase in dyspnoea, sputum volume, and sputum virulence
  • have two of the cardinal symptoms if increased purulence of sputum is one of the two symptoms
  • require mechanical ventilation

Reference

  1. Global Initiative for Chronic Obstructive Lung Disease (GOLD): Global Strategy for the Diagnosis, Management, and Prevention of COPD. 2013. www.goldcopd.org

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