Several remarkable advances in the therapy for chronic obstructive pulmonary disease (COPD) have occurred in the past year. Evaluation of medical therapy for airflow obstruction has been expanded to include not only the usual physiological factors but also the clinical factors of quality of life and cost-effectiveness. Ventilatory therapy for acute respiratory failure in COPD has been improved for patients who do not require immediate endotracheal intubation. Last, new surgical approaches for the treatment of severe emphysema are being evaluated. This update will review these new approaches to the treatment of COPD.
Recently, a new long-acting β2-agonist, salmeterol xinafoate, has been shown to be efficacious and approved by the Food and Drug Administration for the treatment of asthma and other types of COPD.1 The duration of action of salmeterol is 8 to 12 hours. Thus, it can be taken only twice a day compared with the usual
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