Table of Contents
ISRN Pulmonology
Volume 2013 (2013), Article ID 582807, 11 pages
http://dx.doi.org/10.1155/2013/582807
Review Article

Pharmacotherapy of Chronic Obstructive Pulmonary Disease: A Clinical Review

1Department of Pathophysiology, National Koranyi Institute of TB and Pulmonology, Piheno ut 1, Budapest 1121, Hungary
2Department of Pulmonology, National Koranyi Institute of TB and Pulmonology, Piheno ut 1, Budapest 1121, Hungary

Received 11 January 2013; Accepted 7 February 2013

Academic Editors: A. Celi, A. Kurdowska, A. Miyazato, and A. Yokoyama

Copyright © 2013 Balazs Antus. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity worldwide. In addition to generating high healthcare costs, COPD imposes a significant burden in terms of disability and impaired quality of life. Unlike many leading causes of death and disability, COPD is projected to increase in many regions of the world as the frequency of smoking is rising and the population is aging. The pharmacological treatment of COPD includes bronchodilators to relax smooth muscle, such as β2-agonists (salbutamol, terbutaline, and fenoterol, short-acting β2-agonists as well as salmeterol, formoterol, and indacaterol, and long-acting β2-agonists) and anticholinergics, such as ipratropium, oxitropium (short-acting anticholinergic), and tiotropium (long-acting anticholinergic). Although airway inflammation in COPD poorly responds to steroids, several inhaled corticosteroids (fluticasone, budesonide, and beclomethasone) are in use in combination with long-acting β2-agonists. Other medications include theophylline (both a bronchodilator and a phosphodiesterase inhibitor) and the phosphodiesterase-4 antagonists, such as roflumilast. Finally, a number of novel long-acting anticholinergics and β2-agonists with once- or twice-daily profiles are in development and clinical testing.