Based on latest available evidence, antibiotics should be given to COPD patients: Patients with acute exacerbation of the three main signs are: Increased dyspnea, sputum volume Increased, Increased sputum purulence (Evidence B), or patients with acute exacerbation of the two main signs , if the increase in sputum purulensi is one of them (Evidence C) Patients with severe exacerbations requiring mechanical ventilation, both invasive and non-infvasif (Evidence B)
Bronchiectasis is a disease that is potentially preventable actually stop smoking. Once bronchiectasis occurs the patient will require complex therapeutic efficacy is still debated by experts. This disease is progressive and irreversible costly both personal and community.
Treatment
- Inhaled anticholinergics first line therapy, the dose should be quite high: 2 puffs 4 - 6x/day, if difficult, use a nebulizer 0.5 mg every 4-6 hours prn, exp: ipratropium bromide or oxytropium.
- Sympathomimetic second line therapy: Terbutaline, salbutamol.
- Anticholinergic and sympathomimetic combination to enhance the effectiveness of Methyl ksantin many ADR, used if the other does not work.
- Mukolitik assist sputum dilution, but did not improve the air flow is still controversy over whether or not clinically useful
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