Therapeutic algorithm for chronic obstructive pulmonary disease

Article Abstract:

Chronic obstructive pulmonary disease (COPD) is characterized by the impairment of the normal function of the lungs. The first step in treating COPD is to prevent further damage to the lungs. Therefore, patients with COPD who smoke should stop smoking. Smoking irritates the lungs and can enhance lung tissue damage. Studies have shown that quitting smoking can result in improvements in lung function. Annual influenza vaccines have been prescribed for patients with COPD to prevent lung infections, which can increase the severity of COPD. Anticholinergic drugs, such as ipratropium, are potent bronchodilators used to treat patients with COPD. These drugs have advantages over beta-adrenergic agonists in treating COPD because they have fewer side effects, produce greater and longer lasting bronchodilation, and they remain effective after long-term use. Beta-adrenergic agonists, because they are fast-acting, are more effective in treating asthma. However, beta-adrenergic agonists can cause blood vessels to dilate and can have adverse effects on the heart. Anticholinergic drugs are not absorbed from the lungs into the blood and do not have adverse effects on the blood vessels and heart. This is important for treating patients with COPD who also have heart disease. When anticholinergic drugs and beta-adrenergic agonists fail, corticosteroids should be administered. After an appropriate drug therapy program has been selected, patients with COPD may also benefit from exercise, such as walking, stair climbing, or cycling. Patients with low levels of oxygen in their blood (hypoxemia) may benefit from supplemental oxygen delivered through nose tubes or a mask. This is a general therapeutic outline; it is stressed that any treatment should be prescribed with the particular needs of each patient in mind and, therefore, will vary. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment

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Anticholinergic bronchodilators for adult obstructive airways disease

Article Abstract:

Anticholinergic bronchodilators are drugs that dilate the air passages in the lungs. They work by preventing muscle contraction in the lung air passages. Ipratropium bromide, oxitropium, and atropine methonitrate are anticholinergic bronchodilators that have been used to treat patients with asthma and chronic obstructive lung diseases (COPD), such as emphysema and bronchitis. These drugs are among the most potent available for dilating the lung air passages and for treating COPD. They have few adverse or side effects because they are not absorbed from the lungs into the blood. These drugs have a slow onset of action, but the bronchodilator effect is long-lasting. Beta-adrenergic agonists, such as albuterol, are another class of drugs that are used to dilate the lung air passages. These drugs have a more rapid onset of action than the anticholinergic drugs and are more effective in treating patients with asthma. Studies that have compared albuterol with ipratropium have showed that albuterol is more effective in treating asthma than ipratropium. However, other studies have shown that the combined use of a beta-adrenergic agonist and an anticholinergic drug is more effective in opening the lung air passages than either agent used alone. It has been reported that as patients grow older they become less responsive to treatment with beta-adrenergic agonists, but not to anticholinergic agents. This implies that anticholinergic agents may be more useful in treating older patients with asthma. (Consumer Summary produced by Reliance Medical Information, Inc.)

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The influence of anticholinergic agents on treatment for bronchitis and emphysema

Article Abstract:

Acetylcholine is a chemical that is made and released from nerve endings that are in close contact with muscle tissue; it causes muscle to contract. In the lungs, it results in constriction of the air passages, thereby reducing the amount of air that can get into the lungs. Anticholinergic agents, such as atropine and ipratropium bromide, are drugs that prevent acetylcholine from causing muscle contraction. They are used to dilate lung air passages in patients with chronic obstructive pulmonary diseases (COPD), such as emphysema and bronchitis. Atropine was discovered in the early 1800s, and was the first drug used to treat respiratory disorders. In recent years, more effective and less toxic drugs have been developed. Ipratropium bromide is a relatively new drug that has been shown to be effective in treating COPD. Several studies have reported that this drug is superior to drugs called beta-adrenergic agonists for treating COPD, because it causes greater bronchodilation and produces a longer lasting effect. Ipratropium bromide has a slow onset of action and has few adverse or side effects. It appears to be more effective in treating bronchitis and emphysema than asthma. However, the beta-adrenergic agonist drugs have a more rapid onset of action and are more appropriate for emergency situations, such as during an asthma attack, when fast relief is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Bronchitis, Atropine

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