Therapeutic target
- Improvement of the symptomatology
Therapy recommendations
In emphysema, analogous to COPD, the following staged regimen is used depending on the exact extent:
| Inhaled broncho-dilators (drugs that dilate the bronchi).
If needed |
Inhaled broncho-dilatorsas continuous therapy. | Inhaled glucocorticoids (synonym: inhaled steroids, ICS). |
Oxygen therapyup to 16-24 h/d | |
| Grade 1 (light) |
+ |
– | – | – |
| Grade 2 (moderately severe) |
+ |
+ | – | – |
| Grade 3 (heavy) |
+ |
+ | + | – |
| Grade 4 (very difficult) |
+ |
+ | + | + |
None of the drugs shown can prevent progression of the disease.
Furthermore, ß-sympathomimetics (drugs that mimic the action of the catecholamines epinephrine and norepinephrine in the sympathetic nervous system via activation of β2-adrenoceptors) and anticholinergics (synonym: parasympath(ic)olytic; acts to relax (= relaxes) smooth muscle and inhibits secretion) may be used.
Oxygen
- Oxygen should never be administered in an uncontrolled manner in the emphysemic patient
- As a long-term therapeutic agent only in chronic hypoxia (deficient supply of oxygen) with a paO2 < 55 mmHg, when there is no tendency to hypercapnia (increased carbon dioxide content in the blood)
- If there is a threat of respiratory insufficiency (disturbance of external (mechanical) breathing), choose non-invasive or invasive forms of ventilation.
See also under “Further therapy.”
