ABSTRACT
Dyspnea is the most common symptom in chronic obstructive pulmonary
disease (COPD) and is a major contributor to poor health status (see Chapter
11). It follows that alleviation of this distressing symptom is one of the most
important goals of management for this disease. Indeed, this objective has been highlighted in recent national and international guidelines (1,2). Bronch-
odilator therapy is the first step in themanagement of the dyspneic patient with
COPD. Recent studies have confirmed that modern bronchodilator therapy is
effective in achieving meaningful symptomatic improvement, even in patients
with advanced disease. Moreover, there is evidence that the addition of
inhaled corticosteroids (ICS) to long-acting beta-agonists provides enhanced
benefit for relief of breathlessness than achieved with either agent alone.
