FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 328:1017-1022 April 8, 1993 Number 14 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article by Matz, R. PubMed Citation

The term "chronic obstructive pulmonary disease" (COPD) refers to a spectrum of chronic respiratory diseases characterized by cough, sputum production, dyspnea, airflow limitation, and impaired gas exchange. Most often associated with cigarette smoking, COPD is estimated to affect at least 15 million Americans and is the fifth leading cause of death in the United States¹. Indeed, the death rate has risen by 22 percent in the past decade, and the mortality rate 10 years after diagnosis is greater than 50 percent². Although many issues remain unresolved, considerable advances have been made in the care of patients with this . . . [Full Text of this Article]

Education

Retarding the Progression of Airflow Limitation

Minimizing Airflow Limitation

Reduced Production of Secretions

Increased Elimination of Secretions

Bronchodilation

Sympathomimetic Agents

Anticholinergic Agents

Theophylline

Corticosteroids

Correcting Secondary Physiologic Alterations

Hypoxemia

Pulmonary Hypertension and Cor Pulmonale

Hypercapnia

Optimizing Functional Capability

Exercise Conditioning

Upper-Extremity Training

Respiratory-Muscle Training

Respiratory-Muscle Rest

Dyspnea

Nutrition

Physical and Occupational Therapy

Psychosocial Rehabilitation

Other Issues in Treatment

₁-Antitrypsin Augmentation

Bullectomy

Lung Transplantation

Conclusion

Source Information

From the Pulmonary Science Division, Departments of Medicine, University of Colorado Health Sciences Center and the National Jewish Center for Immunology and Respiratory Medicine, Denver.

Address reprint requests to Dr. Ferguson at the National Jewish Center, 1400 Jackson St., Denver, CO 80206.

References

Related Letters:

Management of Chronic Obstructive Pulmonary Disease
Matz R., Chinet T. C., Kinshuck D., Malik T., Mulleneisen N. K., Ferguson G. T., Cherniack R. M.
Extract | Full Text  
N Engl J Med 1993; 329:967-968, Sep 23, 1993. Correspondence

This article has been cited by other articles:

• Weinberger, M., Murray, M. D., Marrero, D. G., Brewer, N., Lykens, M., Harris, L. E., Seshadri, R., Caffrey, H., Roesner, J. F., Smith, F., Newell, A. J., Collins, J. C., McDonald, C. J., Tierney, W. M. (2002). Effectiveness of Pharmacist Care for Patients With Reactive Airways Disease: A Randomized Controlled Trial. JAMA 288: 1594-1602 [Abstract] [Full Text]  
• Taylor, J., Kotch, A., Rice, K., Ghafouri, M., Kurland, C. L., Fagan, N. M., Witek, T. J. Jr (2001). Ipratropium Bromide Hydrofluoroalkane Inhalation Aerosol Is Safe and Effective in Patients With COPD. Chest 120: 1253-1261 [Abstract] [Full Text]  
• DAHL, R., GREEFHORST, L. A. P. M., NOWAK, D., NONIKOV, V., BYRNE, A. M., THOMSON, M. H., TILL, D., DELLA CIOPPA, G. (2001). Inhaled Formoterol Dry Powder Versus Ipratropium Bromide in Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 164: 778-784 [Abstract] [Full Text]  
• Ayers, M.L., Mejia, R., Ward, J., Lentine, T., Mahler, D.A. (2001). Effectiveness of salmeterol versus ipratropium bromide on exertional dyspnoea in COPD. Eur Respir J 17: 1132-1137 [Abstract] [Full Text]  
• Young, M., Sparrow, D., Gottlieb, D., Selim, A., Friedman, R. (2001). A Telephone-Linked Computer System for COPD Care. Chest 119: 1565-1575 [Abstract] [Full Text]  
• RENNARD, S. I., ANDERSON, W., ZuWALLACK, R., BROUGHTON, J., BAILEY, W., FRIEDMAN, M., WISNIEWSKI, M., RICKARD, K. (2001). Use of a Long-acting Inhaled {beta}2-Adrenergic Agonist, Salmeterol Xinafoate, in Patients with Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 163: 1087-1092 [Abstract] [Full Text]  
• Teramoto, S., Ishii, T., Luisetti, M., Pignatti, P. F. (2001). No Association of Tumor Necrosis Factor-{{alpha}} Gene Polymorphism and COPD in Caucasian Smokers and Japanese Smokers. Chest 119: 315-316 [Full Text]  
• Hilleman, D. E., Dewan, N., Malesker, M., Friedman, M. (2000). Pharmacoeconomic Evaluation of COPD. Chest 118: 1278-1285 [Abstract] [Full Text]  
• Casaburi, R., Briggs, D. D. Jr., Donohue, J. F., Serby, C. W., Menjoge, S. S., Witek, T. J. Jr. (2000). The Spirometric Efficacy of Once-Daily Dosing With Tiotropium in Stable COPD : A 13-Week Multicenter Trial. Chest 118: 1294-1302 [Abstract] [Full Text]  
• Lone, A. A. (2000). Respiratory Disorders of the Elderly. Journal of Pharmacy Practice 13: 297-307 [Abstract]  
• Hirschmann, J. V. (2000). Do Bacteria Cause Exacerbations of COPD?. Chest 118: 193-203 [Abstract] [Full Text]  
• SEEMUNGAL, T. A. R., DONALDSON, G. C., BHOWMIK, A., JEFFRIES, D. J., WEDZICHA, J. A. (2000). Time Course and Recovery of Exacerbations in Patients with Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 161: 1608-1613 [Abstract] [Full Text]  
• Ferguson, G. T., Enright, P. L., Buist, A. S., Higgins, M. W. (2000). Office Spirometry for Lung Health Assessment in Adults: A Consensus Statement From the National Lung Health Education Program. Chest 117: 1146-1161 [Abstract] [Full Text]  
• LITTNER, M. R., ILOWITE, J. S., TASHKIN, D. P., FRIEDMAN, M., SERBY, C. W., MENJOGE, S. S., WITEK, T. J. Jr. (2000). Long-Acting Bronchodilation with Once-Daily Dosing of Tiotropium (Spiriva) in Stable Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 161: 1136-1142 [Abstract] [Full Text]  
• Hackner, D., Tu, G., Weingarten, S., Mohsenifar, Z. (1999). Guidelines in Pulmonary Medicine: A 25-Year Profile. Chest 116: 1046-1062 [Abstract] [Full Text]  
• Petty, T. L., Mahler, D. A., Donohue, J. F., Rickard, K. A. (1999). Apples and Oranges : Flaws and Guffaws. Chest 116: 1137-1138 [Full Text]  
• Enright, P. L., McClelland, R. L., Newman, A. B., Gottlieb, D. J., Lebowitz, M. D. (1999). Underdiagnosis and Undertreatment of Asthma in the Elderly. Chest 116: 603-613 [Abstract] [Full Text]  
• Cox, G., Whitehead, L., Dolovich, M., Jordana, M., Gauldie, J., Newhouse, M. T. (1999). A Randomized Controlled Trial on the Effect of Inhaled Corticosteroids on Airways Inflammation in Adult Cigarette Smokers. Chest 115: 1271-1277 [Abstract] [Full Text]  
• Weber, E. J., Levitt, M. A., Covington, J. K., Gambrioli, E. (1999). Effect of Continuously Nebulized Ipratropium Bromide Plus Albuterol on Emergency Department Length of Stay and Hospital Admission Rates in Patients With Acute Bronchospasm: A Randomized, Controlled Trial. Chest 115: 937-944 [Abstract] [Full Text]  
• Mahler, D. A., Donohue, J. F., Barbee, R. A., Goldman, M. D., Gross, N. J., Wisniewski, M. E., Yancey, S. W., Zakes, B. A., Rickard, K. A., Anderson, W. H. (1999). Efficacy of Salmeterol Xinafoate in the Treatment of COPD. Chest 115: 957-965 [Abstract] [Full Text]  
• Dorinsky, P. M., Reisner, C., Ferguson, G. T., Menjoge, S. S., Serby, C. W., Witek, T. J. Jr. (1999). The Combination of Ipratropium and Albuterol Optimizes Pulmonary Function Reversibility Testing in Patients With COPD. Chest 115: 966-971 [Abstract] [Full Text]  
• Andel, A. E. V., Reisner, C., Menjoge, S. S., Witek, T. J. (1999). Analysis of Inhaled Corticosteroid and Oral Theophylline Use Among Patients With Stable COPD from 1987 to 1995. Chest 115: 703-707 [Abstract] [Full Text]  
• Campbell, S. (1999). For COPD a Combination of Ipratropium Bromide and Albuterol Sulfate Is More Effective Than Albuterol Base. Arch Intern Med 159: 156-160 [Abstract] [Full Text]  
• Mahon, J. L., Laupacis, A., Hodder, R. V., McKim, D. A., Paterson, N. A. M., Wood, T. E., Donner, A. (1999). Theophylline for Irreversible Chronic Airflow Limitation: A Randomized Study Comparing n of 1 Trials to Standard Practice. Chest 115: 38-48 [Abstract] [Full Text]  
• Russell, C. K., Geraci, T., Hooper, A., Shull, L., Gregory, D. M. (1998). Patients' Explanatory Models for Heart Failure and COPD Exacerbations. Clin Nurs Res 7: 164-188 [Abstract]  
• FERGUSON, G. T., FERNANDEZ, E., ZAMORA, M. R., POMERANTZ, M., BUCHHOLZ, J., MAKE, B. J. (1998). Improved Exercise Performance Following Lung Volume Reduction Surgery for Emphysema. Am. J. Respir. Crit. Care Med. 157: 1195-1203 [Abstract] [Full Text]  
• REPINE, J. E., BAST, A., LANKHORST, I., The Oxidative Stress Study Gro, (1997). Oxidative Stress in Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med. 156: 341-357 [Full Text]  
• Everett, J. A. (1997). Alternatives to Standard Status Asthmaticus Therapy. Journal of Pharmacy Practice 10: 186-199 [Abstract]  
• Tarpy, S. P., Celli, B. R. (1995). Long-Term Oxygen Therapy. NEJM 333: 710-714 [Full Text]  
• Matz, R., Chinet, T. C., Kinshuck, D., Malik, T., Mulleneisen, N. K., Ferguson, G. T., Cherniack, R. M. (1993). Management of Chronic Obstructive Pulmonary Disease. NEJM 329: 967-968 [Full Text]