Exacerbations of COPD: Evaluation and treatment

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In evaluating patients who have exacerbations of chronic obstructive pulmonary disease, ask about symptoms and signs, such as dyspnea and sputum production, that may suggest an infectious cause. Look for evidence of pneumonia, accessory respiratory muscle use, wheezing, hemodynamic instability, and altered mental status. Arterial blood gas analysis is necessary to identify hypoxemia and acute respiratory acidosis. Inhaled β2-agonist therapy reduces dyspnea in most patients and may be combined with ipratropium. Consider giving oral prednisone for mild exacerbations and intravenous methylprednisolone for moderate to severe exacerbations. Antibiotics are indicated for patients who have increased dyspnea, sputum production, and sputum purulence. Those who are treated as outpatients should be closely followed and should be hospitalized if they do not respond adequately to treatment in 3 to 5 days.

Original languageEnglish (US)
Pages (from-to)722-730
Number of pages9
JournalJournal of Respiratory Diseases
Issue number12
StatePublished - 2000

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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