In the United States and worldwide, chronic obstructive pulmonary disease (COPD) carries a large burden of mortality and morbidity. Because the vast majority of COPD cases are due to smoking, it remains a highly preventable disease. Hallmark symptoms of COPD include dyspnea that is progressively worse, chronic cough, sputum production, and recurrent lower respiratory tract infections, and a clinical diagnosis can be confirmed with the use of spirometry measurements. Recent efforts have also focused on identifying the degree of dyspnea and impairment of quality of life when determining the optimal treatment course. Unfortunately, optimal treatment of COPD continues to be a therapeutic challenge, as current medications available for COPD largely do not modify the course of the disease. Smoking cessation in patients who are current smokers has the largest propensity to decrease disease burden and should always remain a priority for clinicians. Treatment selection is guided on severity of symptoms, spirometry measurements, and exacerbation risk.
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