pulmonary disorders
Chronic Obstructive Pulmonary Disease (COPD)
Key Points
Cigarette smoking in susceptible people is the major cause of chronic obstructive pulmonary disease (COPD) in the developed world. Diagnose COPD and differentiate it from disorders that have similar characteristics (eg, asthma, heart failure) primarily by routine clinical information, such as symptoms (particularly time course), age at onset, risk factors, and results of routine tests (eg, chest x-ray, pulmonary function tests). Reductions of FEV1, FVC, and the ratio of FEV1/FVC are characteristic findings. Categorize patients based on symptoms and exacerbation risk into one of 4 groups and use that category to guide drug treatment. Relieve symptoms rapidly with primarily short-acting beta-adrenergic drugs and decrease exacerbations with inhaled corticosteroids, long-acting beta-adrenergic drugs, long-acting anticholinergic drugs, or a combination. Encourage smoking cessation using multiple interventions. 