Historically, the pharmacologic
options for managing COPD included
bronchodilators (β2-agonists,
anticholinergics, and methylxanthines)
and antiinflammatory agents
(inhaled and oral corticosteroids).
Inhaled bronchodilators including the β2-agonists and anticholinergics
improve lung function and are used
for symptomatic management; the
methylxanthines (aminophylline
and theophylline) are recommended
as second-line agents, as they are
less well tolerated and less effective.
4 Inhaled corticosteroid (ICS)
therapy is effective in patients with
severe COPD (an FEV1 of