A stepwise increase in pharmacotherapy depending on the severity of COPD

The overall approach to managing stable COPD should be characterized by a stepwise increase in treatment, depending on the severity of the disease in accordance with JRS COPD guideline. None of the existing medications has been shown to modify the long term decline in lung function that is the hallmark of this disease. Therefore, pharmacothepary for COPD is used to decrease symptoms and/or complications. Smoking cessation and influenza vaccines are the base of pharmacotherapy. And the principal short and long acting bronchodilator treatments are anticholinergics, beta2-agonists, methylxanthines, and a combination of one or more of these drugs. And regular treatment with inhaled glucocorticosteroids should only be prescribed for symptomatic COPD patients with a documented spirometric response to glucocorticosteroids or for those with stage III and repeated exacerbations.