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The Pharmacological Approach to the Elderly COPD Patient

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Abstract

The elderly patient (65 years and older) with chronic obstructive pulmonary disease (COPD) can be a challenge to the clinician. This begins with the correct and early diagnosis, the assessment of disease severity, recognizing complicating comorbidities, determining the burden of symptoms, and monitoring the frequency of acute exacerbations. Comprehensive management of COPD in the elderly patient should improve health-related quality of life, lung function, reduce exacerbations, and promote patient compliance with treatment plans. Only smoking cessation and oxygen therapy in COPD patients with hypoxemia reduce mortality. Bronchodilators, corticosteroids, methylxanthines, phosphodiesterase-4 inhibitors, macrolide antibiotics, mucolytics, and pulmonary rehabilitation improve some outcome measures such as spirometry measures and the frequency of COPD exacerbations without improving mortality. International treatment guidelines to reduce symptoms and reduce the risk of acute exacerbations exist. Relief of dyspnea and control of anxiety are important. The approach to each patient is best individualized. Earlier use of palliative care should be considered when traditional pharmacotherapy fails to achieve outcome measures and before consideration of end-of-life issues.

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Acknowledgments

S. Louie has received payment for lectures and is on the Speaker’s Bureaus for AstraZeneca, Boehringer-Ingelheim, Forest, GlaxoSmithKline, and Pfizer. M. Avdalovic is a paid speaker for Novartis. T. Albertson is a paid speaker for GlaxoSmithKline. A. Chan is a paid speaker for Forest, Intermune, Gilead, and Boehringer-Ingelheim. The other authors have nothing to disclose.

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  1. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of California, 4150 V Street, Suite 3400, Davis, CA, USA

    Timothy E. Albertson, Michael Schivo, Amir A. Zeki, Samuel Louie, Mark Avdalovic & Andrew L. Chan

  2. Veteran’s Administration Northern California Health Care System, Mather, CA, USA

    Timothy E. Albertson, Mark Avdalovic & Andrew L. Chan

  3. Department of Emergency Medicine, University of California, Davis, CA, USA

    Timothy E. Albertson & Mark E. Sutter

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  1. Timothy E. Albertson
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Albertson, T.E., Schivo, M., Zeki, A.A. et al. The Pharmacological Approach to the Elderly COPD Patient. Drugs Aging 30, 479–502 (2013). https://doi.org/10.1007/s40266-013-0080-1

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