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Chronic Obstructive Pulmonary Disease: An Evidence-Based Approach to Treatment With a Focus on Anticholinergic Bronchodilation  Nicholas J. Gross, MD,

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Presentation on theme: "Chronic Obstructive Pulmonary Disease: An Evidence-Based Approach to Treatment With a Focus on Anticholinergic Bronchodilation  Nicholas J. Gross, MD,"— Presentation transcript:

1 Chronic Obstructive Pulmonary Disease: An Evidence-Based Approach to Treatment With a Focus on Anticholinergic Bronchodilation  Nicholas J. Gross, MD, PhD  Mayo Clinic Proceedings  Volume 83, Issue 11, Pages (November 2008) DOI: / Copyright © 2008 Mayo Foundation for Medical Education and Research Terms and Conditions

2 FIGURE 1 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for the treatment of chronic obstructive pulmonary disease at various stages from mild (forced expiratory volume in the first second of expiration [FEV1] ≥80% predicted) to very severe (FEV1 <30% predicted or <50% plus chronic respiratory failure) disease. FVC = forced vital capacity. From Am J Respir Crit Care Med,4 with permission. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 2008 Mayo Foundation for Medical Education and Research Terms and Conditions

3 FIGURE 2 The proposed 3-step algorithm (1, 2, and 3; bold arrows) for treating mild, moderate, and severe chronic obstructive pulmonary disease. GOLD = Global Initiative for Chronic Obstructive Lung Disease. Adapted from Chest,23 with permission from the American College of Chest Physicians. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 2008 Mayo Foundation for Medical Education and Research Terms and Conditions

4 FIGURE 3 Effects of tiotropium and formoterol plus tiotropium on mean forced expiratory volume in the first second of expiration (FEV1). From Eur Respir J,37 with permission from The European Respiratory Society. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 2008 Mayo Foundation for Medical Education and Research Terms and Conditions


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