ABSTRACT
Guidelines for the management and prevention of chronic obstructive pulmonary disease (COPD) have been published by the Global Initiative for Chronic Obstructive Lung Disease, the American Thoracic Society, the European Respiratory Society and the National Institute for Health and Clinical Excellence. Smoking cessation is indicated in all active smokers with COPD, and if pharmacological support is needed to help them to stop, this should be provided. Inhaled therapy, including bronchodilators and steroids, is one of several approaches to COPD management. Spiriva is the only long-acting inhaled anticholinergic that provides 24-hour bronchodilation through prolonged muscarinic M3 receptor blockade. Although commonly used in asthma, inhaled corticosteroids appear to be ineffective for mild to moderate COPD, because of the different nature of the underlying inflammation. Oxygen therapy can be used on an 'as and when needed' basis to relieve symptoms of shortness of breath.
