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Therapie der stabilen COPD

Nicht nur Bronchodilatation!

Treatment of stable COPD

Not just bronchodilation!

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Die COPD ist eine Lungenerkrankung, die besonders bei höherem Schweregrad zunehmend den Charakter einer Systemerkrankung aufweist. Die unterschiedlichen klinischen COPD-Phänotypen erfordern eine individualisierte Therapie. Sie geht über die stadienangepasste Therapie mit Bronchodilatatoren hinaus. Die lang wirksamen β2-Agonisten Formoterol und Salmeterol sowie das lang wirksame Anticholinergikum Tiotropium stellen einen wichtigen Fortschritt in der Basistherapie dar. Inhalative Kortikosteroide sind zur Prävention häufiger Exazerbationen im GOLD-Stadium III und IV indiziert. Bei fortgeschrittenen Erkrankungsstadien werden zunehmend die Diagnostik und Therapie von respiratorischer Insuffizienz, Myopathie, kardiovaskulären Begleiterkrankungen, Osteoporose, Depression und Ernährungsstörungen wichtig.

Abstract

Chronic obstructive pulmonary disease (COPD) is increasingly being recognized as a systemic disease, especially at advanced disease stages. The very different COPD phenotypes require an individualized therapeutic approach. Bronchodilators remain the basis of long-term therapy. Long-acting ß2-agonists and the long-acting anticholinergic tiotropium led to a further improvement in the management of COPD. Inhaled corticosteroids prevent frequent exacerbations in patients with more severe disease. At GOLD stages III and IV more patients will need evaluation and therapy of conditions such as chronic respiratory failure, myopathy, cardiovascular disease, osteoporosis, depression, and nutritional deficits.

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  1. Missionsärztliche Klinik gGmbH, Akademisches Lehrkrankenhaus der Julius-Maximilians-Universität Würzburg

    B. Jany

  2. Missionsärztliche Klinik gGmbH, Akademisches Lehrkrankenhaus der Julius-Maximilians-Universität Würzburg, Salvatorstraße 7, 97064 , Würzburg

    B. Jany

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Jany, B. Therapie der stabilen COPD. Pneumologe 3, 98–109 (2006). https://doi.org/10.1007/s10405-006-0084-1

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