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Management of COPD exacerbations: pharmacotherapeutics of medications

09 July 2020

Focus

02 July 2020

Volume 29 · Issue 13

ISSN (print): 0966-0461

ISSN (online): 2052-2819

Abstract

Chronic obstructive pulmonary disease (COPD) is widely established as a health challenge, with predictions that it will be the third leading cause of global mortality and reduced health status within the next 10 years. Exacerbations of COPD are now the second largest cause of emergency hospitalisation in the UK. The respiratory clinical nurse specialist has an active role in the acute management of COPD exacerbations in the hospital setting, and it is essential that prescribing decisions are made based on the best available evidence. This article critically evaluates the pharmacotherapeutics and evidence base for the use of two medications, salbutamol and amoxicillin, in treating unstable COPD, and discusses implications for clinical practice.

Owing to its major burden on secondary health care, chronic obstructive pulmonary disease (COPD) is widely established as a health challenge, with predictions that it will be the third leading cause of global mortality and reduced health status within the next 10 years (World Health Organization (WHO), 2020). Fluctuations in stable states of COPD is the second largest cause of emergency hospitalisation (National Institute for Health and Care Excellence (NICE), 2011) and, given the expanding COPD population in Northern Ireland (Department of Health, Social Services and Public Safety, 2015) where the author is based, the assessment and management of such individuals is common within the practice of respiratory nurse specialists (RNSs). The RNS can have a direct role in advising and prescribing treatment for this patient population, and it is therefore necessary that the RNS makes prescribing decisions based on the best available evidence.

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Chronic obstructive pulmonary disease

COPD exacerbations

Breathlessness

Dyspnoea

Respiratory system pathophysiology

Amoxicillin

Salbutamol

Pharmacokinetics

Pharmacotherapeutics