Advances in chronic obstructive pulmonary disease
Article first published online: 6 AUG 2013
© 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 43, Issue 8, pages 854–862, August 2013
How to Cite
McDonald, C. F. and Khor, Y. (2013), Advances in chronic obstructive pulmonary disease. Internal Medicine Journal, 43: 854–862. doi: 10.1111/imj.12219
Conflict of interest: Christine McDonald has served on advisory boards for GlaxoSmithKline, Novartis, Pfizer; received conference support from Nycomed; has given presentations at educational meetings sponsored by Boehringer Ingelheim and Novartis.
- Issue published online: 6 AUG 2013
- Article first published online: 6 AUG 2013
- Manuscript Accepted: 28 MAY 2013
- Manuscript Received: 13 NOV 2012
- chronic obstructive pulmonary disease;
- lung disease;
Chronic obstructive pulmonary disease (COPD) is characterised by progressive airflow limitation in the presence of identifiable risk factors. Inflammation is the central pathological feature in the pathogenesis of COPD. In addition to its pulmonary effects, COPD is associated with significant extrapulmonary manifestations, including ischaemic heart disease, osteoporosis, stroke and diabetes. Anxiety and depression are also common. Spirometry remains the gold standard diagnostic tool. Pharmacologic and non-pharmacologic therapy can improve symptoms, quality of life and exercise capacity and, through their effects on reducing exacerbations, have the potential to modify disease progression. Bronchodilators are the mainstay of pharmacotherapy, with guidelines recommending a stepwise escalating approach. Smoking cessation is paramount in managing COPD, with promotion of physical activity and pulmonary rehabilitation being other key factors in management. Comorbidities should be actively sought and managed in their own right. Given the chronicity and progressive nature of COPD, ongoing monitoring and support with timely discussion of advanced-care planning and end-of-life issues are recommended.