What is the preferred bronchodilator treatment in COPD exacerbation?

The preferred bronchodilator treatment for a COPD exacerbation primarily involves the use of short-acting beta agonists (SABAs) and, when necessary, short-acting muscarinic antagonists (SAMAs). This combination helps to rapidly relieve bronchospasm and improve airflow. SABAs, such as albuterol, act quickly by relaxing the muscles of the airways, leading to bronchodilation. When added to a SABA, a SAMA, such as ipratropium, provides further benefits by promoting airway dilation through a different mechanism of action, which can result in enhanced short-term relief of symptoms for individuals experiencing an exacerbation.

In contrast, long-acting beta agonists (LABAs) are generally used for maintenance therapy rather than acute exacerbations, making them less suitable as first-line treatment in this context. Combination inhalers may be beneficial for ongoing management but are not the immediate choice during an acute event. Oral steroids can help reduce inflammation during severe exacerbations but do not directly address the immediate bronchospasm, making them secondary to bronchodilators in acute treatment settings. Therefore, the combination of a short-acting beta agonist with a short-acting muscarinic antagonist provides immediate symptom relief and is the