Skip to main content
NCBI home page
Canadian Family Physician logoLink to Canadian Family Physician
. 1989 Jul;35:1527–1531.

Out-Patient Management of Patients with Chronic Obstructive Lung Disease

Elizabeth Tullis, Ronald F Grossman
PMCID: PMC2280274  PMID: 21248911

Abstract

The treatment of chronic obstructive lung disease is multifaceted. If the patient smokes, he or she must quit. Treatment includes bronchodilator therapy, glucocorticosteroids, antibiotics for acute exacerbations, oxygen therapy for patients with chronic hypoxemia (it can also help patients with nocturnal and exercise-induced hypoxemia), and respiratory rehabilitation for motivated patients. Inhaled β-agonists and anticholinergic agents have additive effects in recommended doses, as do theophylline and β-agonists.

Keywords: chronic obstructive lung disease, pulmonary disorders, respiratory system

Full text

PDF
1527

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albert R. K., Martin T. R., Lewis S. W. Controlled clinical trial of methylprednisolone in patients with chronic bronchitis and acute respiratory insufficiency. Ann Intern Med. 1980 Jun;92(6):753–758. doi: 10.7326/0003-4819-92-6-753. [DOI] [PubMed] [Google Scholar]
  2. Angelillo V. A., Bedi S., Durfee D., Dahl J., Patterson A. J., O'Donohue W. J., Jr Effects of low and high carbohydrate feedings in ambulatory patients with chronic obstructive pulmonary disease and chronic hypercapnia. Ann Intern Med. 1985 Dec;103(6 ):883–885. doi: 10.7326/0003-4819-103-6-883. [DOI] [PubMed] [Google Scholar]
  3. Anthonisen N. R. Long-term oxygen therapy. Ann Intern Med. 1983 Oct;99(4):519–527. doi: 10.7326/0003-4819-99-4-519. [DOI] [PubMed] [Google Scholar]
  4. Anthonisen N. R., Manfreda J., Warren C. P., Hershfield E. S., Harding G. K., Nelson N. A. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med. 1987 Feb;106(2):196–204. doi: 10.7326/0003-4819-106-2-196. [DOI] [PubMed] [Google Scholar]
  5. Aubier M., De Troyer A., Sampson M., Macklem P. T., Roussos C. Aminophylline improves diaphragmatic contractility. N Engl J Med. 1981 Jul 30;305(5):249–252. doi: 10.1056/NEJM198107303050503. [DOI] [PubMed] [Google Scholar]
  6. Aubier M., Murciano D., Viirès N., Lebargy F., Curran Y., Seta J. P., Pariente R. Effects of digoxin on diaphragmatic strength generation in patients with chronic obstructive pulmonary disease during acute respiratory failure. Am Rev Respir Dis. 1987 Mar;135(3):544–548. doi: 10.1164/arrd.1987.135.3.544. [DOI] [PubMed] [Google Scholar]
  7. Barker W. H., Mullooly J. P. Influenza vaccination of elderly persons. Reduction in pneumonia and influenza hospitalizations and deaths. JAMA. 1980 Dec 5;244(22):2547–2549. [PubMed] [Google Scholar]
  8. Burrows B., Earle R. H. Course and prognosis of chronic obstructive lung disease. A prospective study of 200 patients. N Engl J Med. 1969 Feb 20;280(8):397–404. doi: 10.1056/NEJM196902202800801. [DOI] [PubMed] [Google Scholar]
  9. Chan C. S., Brown I. G., Kelly C. A., Dent A. G., Zimmerman P. V. Bronchodilator responses to nebulised ipratropium and salbutamol singly and in combination in chronic bronchitis. Br J Clin Pharmacol. 1984 Jan;17(1):103–105. doi: 10.1111/j.1365-2125.1984.tb05008.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Easton P. A., Jadue C., Dhingra S., Anthonisen N. R. A comparison of the bronchodilating effects of a beta-2 adrenergic agent (albuterol) and an anticholinergic agent (ipratropium bromide), given by aerosol alone or in sequence. N Engl J Med. 1986 Sep 18;315(12):735–739. doi: 10.1056/NEJM198609183151205. [DOI] [PubMed] [Google Scholar]
  11. Fedson D. S. Influenza prevention and control. Past practices and future prospects. Am J Med. 1987 Jun 19;82(6A):42–47. doi: 10.1016/0002-9343(87)90560-2. [DOI] [PubMed] [Google Scholar]
  12. Glezen W. P., Decker M., Perrotta D. M. Survey of underlying conditions of persons hospitalized with acute respiratory disease during influenza epidemics in Houston, 1978-1981. Am Rev Respir Dis. 1987 Sep;136(3):550–555. doi: 10.1164/ajrccm/136.3.550. [DOI] [PubMed] [Google Scholar]
  13. Goldstein R. S., Ramcharan V., Bowes G., McNicholas W. T., Bradley D., Phillipson E. A. Effect of supplemental nocturnal oxygen on gas exchange in patients with severe obstructive lung disease. N Engl J Med. 1984 Feb 16;310(7):425–429. doi: 10.1056/NEJM198402163100704. [DOI] [PubMed] [Google Scholar]
  14. Green L. H., Smith T. W. The use of digitalis in patients with pulmonary disease. Ann Intern Med. 1977 Oct;87(4):459–465. doi: 10.7326/0003-4819-87-4-459. [DOI] [PubMed] [Google Scholar]
  15. Hunter A. M., Carey M. A., Larsh H. W. The nutritional status of patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1981 Oct;124(4):376–381. doi: 10.1164/arrd.1981.124.4.376. [DOI] [PubMed] [Google Scholar]
  16. Leech J. A., Gervais A., Ruben F. L. Efficacy of pneumococcal vaccine in severe chronic obstructive pulmonary disease. CMAJ. 1987 Feb 15;136(4):361–365. [PMC free article] [PubMed] [Google Scholar]
  17. Mendella L. A., Manfreda J., Warren C. P., Anthonisen N. R. Steroid response in stable chronic obstructive pulmonary disease. Ann Intern Med. 1982 Jan;96(1):17–21. doi: 10.7326/0003-4819-96-1-17. [DOI] [PubMed] [Google Scholar]
  18. Newman S. P., Pavia D., Morén F., Sheahan N. F., Clarke S. W. Deposition of pressurised aerosols in the human respiratory tract. Thorax. 1981 Jan;36(1):52–55. doi: 10.1136/thx.36.1.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Taylor D. R., Buick B., Kinney C., Lowry R. C., McDevitt D. G. The efficacy of orally administered theophylline, inhaled salbutamol, and a combination of the two as chronic therapy in the management of chronic bronchitis with reversible air-flow obstruction. Am Rev Respir Dis. 1985 May;131(5):747–751. doi: 10.1164/arrd.1985.131.5.747. [DOI] [PubMed] [Google Scholar]
  21. Williams J. H., Jr, Moser K. M. Pneumococcal vaccine and patients with chronic lung disease. Ann Intern Med. 1986 Jan;104(1):106–109. doi: 10.7326/0003-4819-104-1-106. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES