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Pharmacotherapy for chronic obstructive pulmonary disease

Article information

J Korean Med Assoc. 2019;62(5):277-282
Publication date (electronic) : 2019 May 16
doi : https://doi.org/10.5124/jkma.2019.62.5.277
Yong Suk Jo, MD1orcid_icon, Yong Bum Park, MD1,2orcid_icon
1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
2Lung Research Institute, Hallym University College of Medicine, Chuncheon, Korea.
Corresponding author: Yong Bum Park. bfspark@kdh.or.kr
Received 2019 April 05; Accepted 2019 April 30.

Abstract

Appropriate pharmacologic therapy can reduce symptoms and risk and severity of exacerbations, as well as improve the health status and exercise tolerance of patients with chronic obstructive pulmonary disease. The most important medications for treating chronic obstructive pulmonary disease are inhaled bronchodilators including beta2-agonist and anticholinergics. Inhaled corticosteroids as anti-inflammatory drug should be considered in certain patients with caution considering risk and benefit. The choice within each class depends on the availability of medication and the patient's responses and preferences. Each treatment regimen needs to be individualized as the relationship between severity of symptoms, airflow limitation and severity of exacerbation can differ between patients.

Keywords: Pulmonary disease, chronic obstructive; Respiratory therapy

Notes

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

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© Korean Medical Association
Korean Medical Association

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Figure 1

Figure 1

Classification of patients with chronic obstructive pulmonary disease. FEV1, forced expiratory volume in 1 second; mMRC, modified Medical Research Council dyspnea scale; CAT, chronic obstructive pulmonary disease assessment test.

Figure 2

Figure 2

Pharmacologic treatment algorithms. FEV1, forced expiratory volume in 1 second; AE COPD, acute exacerbation of chronic obstructive pulmonary disease; mMRC, modified Medical Research Council dyspnea scale; CAT, COPD assessment test; SABA, short acting beta2-agonist; LAMA, long acting muscarinic antagonist; LABA, long acting beta2-agonist; ICS, inhaled corticosteroid; PDE4, phosphodiesterase 4. a)Postbronchodilator FEV1 <50%, symptoms of chronic bronchitis, and a history of exacerbations. b)Asthma overlap or high blood eosinophil.

Table 1

Available inhaled bronchodilators in Korea

Table 1

SABA, short acting beta2-agonist; MDI, metered dose inhaler; LABA, long acting beta2-agonist; DPI, dry powder inhaler; SAMA, short acting muscarinic antagonist; LAMA, long acting muscarinic antagonist.

Table 2

Insurance standard of inhaled bronchodilators and inhaled steroids in Korea

Table 2

LAMA, long acting muscarinic antagonist; LABA, long acting beta2-agonist; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; ICS, inhaled corticosteroid.