[Treatment of COPD].
Identifieur interne : 000227 ( France/Analysis ); précédent : 000226; suivant : 000228[Treatment of COPD].
Auteurs : Nicolas Roche [France] ; Gérard HuchonSource :
- La Revue du praticien [ 0035-2640 ] ; 2011.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- physiopathology : Pulmonary Disease, Chronic Obstructive.
- therapy : Pulmonary Disease, Chronic Obstructive.
- Humans, Practice Guidelines as Topic.
Abstract
COPD treatment begins with smoking cessation and influenza and pneumococcal vaccines. Bronchodilators are indicated when dyspnea on exertion is reported (usually, FEV1 < 80% predicted). On-demand short-acting agents are chosen when dyspnea is intermittent, daily long-acting agents are administered once dyspnea occurs in daily life activities. In all cases, anticholinergics and beta2 agonists can be associated when one class is not sufficiently effective. In patients with FEV1 < 50% predicted (budesonide-formoterol) or 60% predicted (fluticasone-salmeterol), repeated exacerbations and symptoms despite maintenance bronchodilators, fixed associations are indicated. When a handicap persists on pharmacological treatment, respiratory rehabilitation centered on education and exercise training has to be proposed. Care for COPD has to integrate treatment of comorbidities such as cardio-vascular diseases, anxiety-depression, malnutrition, muscle dysfunction, osteoporosis, anemia ... Ongoing research aims at identifying new therapeutic targets, focusing on inflammation, remodeling, protease-antiprotease balance, oxidative stress, lung regeneration/repair and mucus production.
PubMed: 21826920
Affiliations:
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pubmed:21826920Le document en format XML
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Bronchodilators are indicated when dyspnea on exertion is reported (usually, FEV1 < 80% predicted). On-demand short-acting agents are chosen when dyspnea is intermittent, daily long-acting agents are administered once dyspnea occurs in daily life activities. In all cases, anticholinergics and beta2 agonists can be associated when one class is not sufficiently effective. In patients with FEV1 < 50% predicted (budesonide-formoterol) or 60% predicted (fluticasone-salmeterol), repeated exacerbations and symptoms despite maintenance bronchodilators, fixed associations are indicated. When a handicap persists on pharmacological treatment, respiratory rehabilitation centered on education and exercise training has to be proposed. Care for COPD has to integrate treatment of comorbidities such as cardio-vascular diseases, anxiety-depression, malnutrition, muscle dysfunction, osteoporosis, anemia ... Ongoing research aims at identifying new therapeutic targets, focusing on inflammation, remodeling, protease-antiprotease balance, oxidative stress, lung regeneration/repair and mucus production.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement><orgName><li>Sorbonne Paris Cité</li><li>Université Paris-Descartes</li></orgName></list><tree><noCountry><name sortKey="Huchon, Gerard" sort="Huchon, Gerard" uniqKey="Huchon G" first="Gérard" last="Huchon">Gérard Huchon</name></noCountry><country name="France"><region name="Île-de-France"><name sortKey="Roche, Nicolas" sort="Roche, Nicolas" uniqKey="Roche N" first="Nicolas" last="Roche">Nicolas Roche</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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