How should symptoms of exacerbations be treated in COPD patients?

In the management of exacerbations in patients with Chronic Obstructive Pulmonary Disease (COPD), initiating a Long-Acting Beta-Agonist (LABA) or Long-Acting Muscarinic Antagonist (LAMA) is a commonly recommended approach. LABAs and LAMAs work by providing bronchodilation, which helps to relieve symptoms of breathlessness and improves airflow. These medications can effectively reduce the frequency and severity of exacerbations when used as maintenance therapy.

During an exacerbation, the goal is to rapidly alleviate symptomatic distress and restore optimal breathing function. LABAs and LAMAs are designed for long-term control but can also provide quick relief of acute symptoms when an exacerbation occurs. Their use as first-line treatments is supported by clinical guidelines, which emphasize the importance of bronchodilation in managing exacerbated symptoms.

While high-dose inhaled corticosteroids (ICS) might be used in certain contexts, they are not the primary treatment for exacerbations but rather for underlying inflammation management over time. Long-term oxygen therapy is indicated for patients with significant resting hypoxemia, not as a first response to symptom exacerbation. Oral antibiotics are warranted primarily when there is evidence of a bacterial infection, such as increased sputum