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Combined treatments for chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a disabling condition with breathlessness caused by symptoms of chronic bronchitis and emphysema. The productive cough characteristic of bronchitis reflects an abnormal response in the mucus glands that usually operate to keep the airways moist. The chronic inflammation of these small airways causes thickened walls that are blocked by the excess mucus. In emphysema the tiny air sacs (alveoli), where gas exchange takes place, are reduced and narrowed so complete emptying of the lungs becomes impossible. This leads to ‘dynamic hyperinflation’, which increases the work of breathing and lowers the efficiency of respiratory muscles, so increasing breathlessness.

Chronic obstructive pulmonary disease can cause a build-up of mucus and gradual breakdown of the lungs

Picture credit: Science Photo Library

Bronchodilator treatment includes long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs). New treatments with different mechanisms of action are becoming available; LABAs and LAMAs can now be combined in a once-daily inhaler used for maintenance treatment. Combining the different action of these two substances can improve lung function more than giving them individually.

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