COPD-DRUGS

SUMMARY

1. LABA, LAMA or ICS? LAMA may be superior to LABA in reducing exacerbations with less adverse events.

2. LAMA + LABA probably better than LABA + ICS (Cochrane review, FLAME trial).

3. Significant adverse effects of corticosteroids: increased risk of pneumonia, easy bruising, cataracts, osteoporosis.

4. Triple therapy? IMPACT study showed reduced exacerbation with similar SE for steroids.

5. ICS should only be used in those with moderate to severe disease and not as first line.

6. Other drugs: mucolytics improve airway clearance; theophylline, beta-blockers & long-term antibiotics have no evidence.

*KEY
LAMA; Long-Acting Muscarinic Antagonists
LABA:Long-Acting Beta2 Agonist
ICS: Inhaled Corticosteroids

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].