Question

A patient with COPD was given a SABA three weeks ago for symptom relief. She comes to the clinic today with reports that symptoms have slightly improved but not completely. What is the first line treatment for mild COPD if symptoms cannot be controlled with SABA alone?

a. Add Salmeterol
b. Add Tiotropim (Spiriva)
c. Add Ipratropium (Atrovent)
d. Add ICS

Answer 1

For mild COPD not well controlled by SABA alone, the first line treatment is to add Ipratropium (Atrovent), a long-acting anticholinergic bronchodilator, to the patient's regimen.

Step-by-step explanation:

The first-line treatment for mild Chronic Obstructive Pulmonary Disease (COPD) where symptoms are not completely controlled with a Short-Acting Beta Agonist (SABA) is to add a long-acting bronchodilator. The addition of Ipratropium (Atrovent), an anticholinergic bronchodilator, is recommended for the ongoing management of COPD symptoms. Ipratropium can be used alone or in combination with SABA. While the use of Inhaled Corticosteroids (ICS) is a treatment option for COPD, it is generally reserved for more severe cases, particularly in those with frequent exacerbations.