Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Background
A condition of progressive lung disease where it restricts airflow, which causes breathing difficulties is known as COPD.Â
32 million individuals are affected by COPD, and it is the third leading cause of death in the US. COPD arises emphysema and chronic bronchitis that causes breathlessness in progressive lung diseases.Â
Major cause of COPD is prolonged inhalation of pollutants, mainly from smoking.Â
Epidemiology
NHIS finds 18 emphysema cases per 1000 persons and 34 chronic bronchitis cases per 1000. Global COPD prevalence is unclear, but it ranges from 7% to 19%.Â
Burden of Obstructive Lung Disease study showed global obstructive lung disease prevalence at 10.1%, men at 11.8% and women at 8.5%.Â
Underdiagnosed disease, patients seek care in late stages, which causes issues with diagnosis and treatment effectiveness.Â
Anatomy
Pathophysiology
COPD causes chronic changes in large airways, small bronchioles, and lung parenchyma. Â
Airway remodelling is a process characterized by the thickening of airway walls, increased mucus production, and fibrosis, which result in long-term inflammation in the airways.Â
Etiology
Smoking causes macrophages to release chemicals that destroy respiratory tissue. Second-hand smoke harms lungs, worsens asthma, and raises risk of respiratory infections. Â
Airway responsiveness in smoking patients increases risk of COPD, that occurs accelerated decline in lung function.Â
Genetics
Prognostic Factors
The absolute mortality rates for US patients aged 25 and older due to COPD were 77.3 deaths per 100,000 males and 56.0 deaths per 100,000 females.Â
It is found that heart disease, depression, underweight are linked to lower health-related quality of life in COPD.Â
Clinical History
COPD affects older adults, mostly diagnosed individuals over 40 years old.Â
Â
Physical Examination
Respiratory AssessmentÂ
Chest ExaminationÂ
Peripheral ExaminationÂ
Functional AssessmentÂ
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Initial mild symptoms progress to worsen severity and frequency with cough, shortness of breath during exertion.Â
Exposure to irritants, weather changes, or illnesses may trigger symptoms.Â
Differential Diagnoses
AsthmaÂ
Congestive Heart FailureÂ
Pulmonary EmbolismÂ
BronchiectasisÂ
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
The use of Bronchodilator therapy, oxygen therapy and pulmonary rehabilitation is very effective in the treatment of COPD.Â
Supportive care and preventive measures should be considered to improve the overall health and quality of life of patients.Â
Medication with inhaled corticosteroids and Phosphodiesterase-4 (PDE-4) Inhibitors should be given to patients. Â
Appointments with medical physicians and preventing recurrence of disorder is an ongoing life-long effort.Â
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
use-of-a-non-pharmacological-approach-for-treating-copd
Patients should stop smoking to prevent further damage to their lungs.Â
Patients should avoid environments with high levels of smoke and always stay inside a smoke-free environment.Â
Patient should stay in adequate conditions with good ventilation, air quality and a clean environment.Â
Education should be given to individuals about cautious with activities that could cause pulmonary disease.Â
Use of Anticholinergics drugs
Ipratropium bromide: It is used with a beta-2 agonist that enhances bronchodilation with 2 to 4 puffs administered every 6 to 8 hours. It has a slow onset and longer duration and is less ideal for as-needed use.Â
Tiotropium: Quaternary ammonium compound causes bronchodilation through M3 receptor inhibition thus they have anticholinergic and antimuscarinic effects.Â
Use of Xanthine Derivative
Theophylline metabolized by liver enzyme system which affected by age, heart conditions, liver issues. Monitor serum levels to prevent toxicity.Â
Use of Phosphodiesterase-4 Inhibitors
Roflumilast inhibits PDE-4, which reduces exacerbations and symptoms in severe COPD patients.Â
Use of Corticosteroids (Inhaled)
Fluticasone relaxes muscles, reduces inflammation, lowers hyperresponsiveness in airways, inhibiting bronchoconstriction.Â
Use of Antibiotics
Cefuroxime: It is a second-gen cephalosporin, that binds to penicillin-binding proteins and inhibits transpeptidation for cell wall death.Â
Â
use-of-intervention-with-a-procedure-in-treating-copd
Direct bronchoscopy administers bronchodilators for targeted airway relief.Â
Bronchial Thermoplasty: Thermal energy delivered to airway walls reduces smooth muscle mass to improve airflow in patients.Â
Endobronchial stents help manage severe airway blockage from COPD complications by maintaining airway openness and enhancing airflow.Â
use-of-phases-in-managing-copd
A detailed family history and physical examination of patient is conducted by healthcare specialist in diagnosis phase to identify signs and symptoms of pulmonary disease.Â
The regular follow-up visits with the physician are required to check the improvement of patients and newly observed complaints.Â
Long-term management phase is a very important phase which involves continuous monitoring, supportive care, and surveillance for late effects of treatment.Â
Medication
20
mg
inhaled by nebulizer twice a day
or
1 or 2 capsules inhaled every 12 hours (Do not exceed 4 capsules/day)
15
mcg
oral inhalation twice a day
1 capsule (75 mcg) is inhaled once a day
Nebulization solution: 0.63 mg to 1.25mg oral inhalation every 1 hour for 2 to 3 doses or as needed
Metered-dose inhaler: 1 to 2 oral inhalations every 1 hour for 2 to 3 doses or as needed
Inhaler:
2
actuations
every 6 hrs
Do not exceed 12 actuations per day
Nebulizer: 2.5 mL every 6-8hours
MD:
1 - 1
mcg/m²
Capsules
Aerosol
3 times a day
1 - 1
minutes
CM
Dose Adjustments
AD
500
mcg
Tablet
Orally 
once a day
4
weeks
Inhalation mouth spray:
Mouth spray
Inhalation
Each actuation=2.5mcg tiotropium(3.124mcg tiotropium bromide monohydrate) and 2.5mcg olodaterol(2.736mcg olodaterol hydrochloride
Chronic obstructive pulmonary disorder
Two inhalations orally every day at the same time
200
mg
Orally 
every 12 hrs
10
days
Note: It is indicated for Acute Bronchitis & Acute Exacerbation of Chronic Bronchitis
glycopyrrolate inhaled and formoterolÂ
Mouth spray
Orally inhaled
twice a day
Two inhalations (Formoterol 18mcg/ Glycopyrrolate inhaled 9 mcg for each inhalation)
Do not exceed two inhalations per day
Mild/moderate/severe:
875
mg
every 12 hrs or 500mg every 8hrs
Acute exacerbation:
500 mg oral tablet immediate release every 12 hours for 5 to 7 days
Note: Not recommended for with risk infection of Pseudomonas
chronic exacerbation
:
400mg orally/intravenous every day for five days
320mg orally every day for five days
One inhalation orally twice a day. Do not exceed one inhalation per day
Indicated for Acute Exacerbations of Chronic Bronchitis:
400
mg/day
Orally 
Single dose or divided every 12hr
Aerosol Metered dose inhaler
1 to 2 inhalations in 2-3 doses every hour, then every 2 to 4 hours
In the case of mild/moderate infections: 500 mg orally every 12 hours or 400 mg intravenously every 12 hours for 7-14 days
In the case of severe/complicated infections: 750 mg orally every 12 hours or 400 mg intravenously every 8 hours for 7-14 days
Limitations for usage: Reserve the fluoroquinolones for patients who are voided of available treatment options for chronic bronchitis
A dose of 500 mg orally every 12 hours or 250 mg orally every 6 hours is indicated in chronic bronchitis infection
3 days of 500 mg orally every day OR Instead, take 500 mg orally in a single dosage on Day 1, then 250 mg orally every day from Days 2 to 5
Indicated for Cancer, skin sores, asthma, bronchitis :
4 mg of flower tops orally three times a day
Or
4 gm of flower tops in 150 ml of water;1 cup of tea orally three times a day
Or
1.5-3 ml of liquid extract orally three times a day;1:1 in 25% alcohol
1-2 ml of tincture orally three times a day;1:10 in 45% alcohol
Indicated for Cancer, skin sores, asthma, bronchitis :
4 mg of flower tops orally three times a day
Or
4 gm of flower tops in 150 ml of water;1 cup of tea orally three times a day
Or
1.5-3 ml of liquid extract orally three times a day;1:1 in 25% alcohol
1-2 ml of tincture orally three times a day;1:10 in 45% alcohol
Exacerbation of chronic bronchitis by acute bacteria Take 400 mg orally after every 12 hours up to 10 days
inhaling 400 mcg (1 puff) orally two times daily
Using a mouthpiece on a nebulizer, inhale 175 mcg orally every day
Administer every day at the same time
Do not exceed 175mg daily once
Dose Adjustments
Renal impairment
Any level of impairment: No change in dose is necessary.
Patients with COPD with substantial renal impairment should be monitored for systemic antimuscarinic side effects.
Hepatic impairment
Mild-to-severe: Safety has not been determined; individuals with any degree of hepatic impairment are not recommended
It is indicated in the maintenance of bronchospasm that is linked to COPD, helping in COPD exacerbations
Spiriva Handihaler- 2 inhalations from a capsule orally each day through the HandiHaler device
Spiriva Respimat- 2 actuation of 2.5 mcg each, inhaled orally daily
indacaterol, inhaled/glycopyrrolate inhaledÂ
Indicated for long-term maintenance of COPD
Inhale the contents orally through one capsule every 12 hours by a neo haler device
umeclidinium bromide/vilanterol inhaledÂ
Indicated for long-term maintenance of COPD that includes emphysema and chronic bronchitis
62.5 mcg/25mcg as one actuation inhaled orally each day
Do not exceed more than one inhalation each day
budesonide inhaled/formoterol/glycopyrrolate inhaledÂ
2 inhalations orally two times daily
Dosage Modifications
Renal impairment
Study not carried out
Study not carried out
Dosing Considerations
Limitations of use: Not suggested for in acute bronchospasm
Aerosol: Administer 100 mcg/20 mcg (1 metered-dose inhaler actuation) every six hours
Do not exceed more than six actuations daily.
Nebulizer: Administer 3ml inhalation every 6 hours.
Do not exceed 3ml every 4 hours.
(off-label):
By using a dry powder inhaler, The administration of batefenterol at a dose of 300 µg for a duration of 42 days
Note: The dosage of 300 µg of batefenterol could be considered as the most suitable for clinical trials (phase III)
Indicated as mucolytic agent:
Administer 750 mg to 2.25 g daily in three to four divided doses
Take a dose of 20 mcg orally two times a day
Daily dose should not be more than 60 mcg
Inhaled a dose of 20 mcg up to 4 times daily
Indicated for Chronic bronchitis
400 mg to 600 mg orally one time a day for nearly 10 days
Community-acquired pneumonia
600 mg orally one time a day for nearly 10 days
Uncomplicated gonorrhea
400 mg orally one time
Cervicitis or Nongonococcal urethritis
400 mg orally one time a day for nearly 7 days
For one week, take 400 mg two times a day by oral route
As metered-dose aerosol:
Inhaled dose of 250 to 500 mcg when required
Dose should not be more than 8 times in a day
Do not repeat dose in less than 1 hour
Take 400 mg by oral route one time daily for ten days duration
It assesses four separate inhaled abediterol dosages at 0.625 ug, 2.5 ug, 5 ug & 10 ug Comparing the results to a placebo, it was evident that all doses considerably improved bronchodilation Comparing the doses of 2.5, 5, and 10 ug to the active comparator, further improvements were observed
5 ml of this drug every 3 to 5 hours is recommended, which should be at most 30 ml daily
This drug is used for treating bronchial congestion and bronchospasm, which are associated with acute and chronic bronchitis
115 mg of etophylline and 35 mg of theophylline is given once a day
It is used as a respiratory stimulant used in the therapy for acute respiratory failure such as COPD
The usual dose via oral administration given as a tablet is 50 -100 mg, which is divided into two doses per day
The usual dose via IV administration is 1-3 mg/kg per day, which is given in divided doses which is infused for over 2 hours
Dose Adjustments
Limited data is available
Administer 1 to 2 g once or twice a day intramuscularly or intravenous infusion.
Maximum dose-4 g/day.
Renal impairment
CrCl 10 to 30ml/min-Administer 1 to 2 g every day.
CrCl<10ml/min- Administer 0.5 to 1 g every day.
Take a dose of 100 mg orally two times daily
Aerosol: 100mcg albuterol /20mcg ipratropium bromide (1 actuation of metered-dose inhaler) every 6 hours; should not exceed more than 6 actuations/day
Nebulizer solution: 3 mL is inhaled every 6hours; should not exceed more than 3 mL every 4hours
Take one tablet/capsule after the breakfast with a glass of water. Dose can be repeated every six hours, should not exceed more than four capsules daily
solution
Inhalation
Using the nebulization system, inhale the contents of the vial two times a day
Capsules for inhalation
using an inhaler, inhale the capsule contents twice daily
500 mg is given orally once every day for one week
Administer 2 inhaled aerosols dose at an interval of minimum 1 to 3 minutes followed by a third inhalation
Take a dose of 32 mg orally daily
Administer 150mg twice a day, can increase the dose to 300mg to 450mg twice a day based on the patient's tolerance.
375
mg
Tablets
Orally 
twice a day
2
weeks
Dose Adjustments
Off-label
280
mcg
Inhalation
once a day
Off-label
budesonide and formoterol (inhalation)Â
160 mcg/9 mcg (2 divided doses of 80 mcg/4.5 mcg) every 12hr
should not exceed more than 320 mcg/9 mcg q12hr
Dose Adjustments
Dosing considerations:
Asthma: 80 mcg/4.5mcg should be given if response is inadequate after 1-2 weeks.
Chronic obstructive pulmonary disease (COPD): the only treatment dose is 160 mcg/4.5 mcg.
amoxicillin and clavulanate potassiumÂ
500 mg orally 3 times a day or 875 mg orally 2 times daily 7-10 days
It is used to treat obstructive lung illnesses like COPD and asthma
It is used to treat the symptoms of lung problems, such as wheezing, dyspnea, and tightness in the chest
The recommended usual dose per day is 400 mg two or three times with a maximum permissible limit is 1200 mg per day
Dose Adjustments
Limited data is available
It is mostly recommended for respiratory tract infections, chronic bronchitis, and urinary tract infections
The usual recommended single dose per week only once is 2 g via oral administration
Dose Adjustments
Reduction in dosage is needed depending upon the condition
Liquid Extract
Administer 0.3ml to 1.0 ml orally thrice a day;60% ethanol
Topical Mouthwash
Administer 6g dried herb with 150 ml water. Rinse thrice or twice a day
Rhizome/Dried root/Tea
Administer 0.5 to 1g orally thrice a day
Tincture
Administer 2 to 4 ml orally thrice a day;60% ethanol
Indicated for Acute bacterial exacerbations of the COPD
500 mg orally four times a day for nearly three days
or Day-1: 500 mg orally one time Day-2 to Day-5: 250 mg orally every day
batefenterol (Investigational)Â
Off-label:
By using a dry powder inhaler, the administration of batefenterol at a dose of 300 µg for a duration of 42 days
Note: The dosage of 300 µg of batefenterol could be considered as the most suitable for clinical trials (phase III)
Mild/moderate/severe :
45 mg/kg daily divided in doses for every 12hrs or 40 mg/kg per day in divided doses for every 8hrs
Community-acquired pneumonia (Off-label use)
<3 months: Safety and effectiveness have not been established
Age: ≥3 months
immediate release (IR):
Empirical treatment:
90 mg/kg/day orally, divided 2 times a day 10 days
maximum daily dose should not exceed 4,000 mg
Group A Streptococcus:
50-75 mg/kg/day orally, divided 2 times a day 10 days
maximum daily dose should not exceed 4,000 mg
H. influenza:
75-100 mg/kg/day orally, divided 3 times a day 10 days
maximum daily dose should not exceed 4,000 mg
S. pneumoniae:
90 mg/kg/day orally, divided 2 times a day 10 days or 45 mg/kg/day divided 2 times a day 10 days
maximum daily dose should not exceed 4,000 mg
Indicated as mucolytic agent:
Children 12 to under 15 years: Administer 100 to 750 mg thrice daily.
Children 6 to 11 years: Administer 100 to 250 mg thrice daily.
Children 2 to 5 years: Administer 100 mg twice or 62.5mg 125mg four times daily.
For <2 years old:
Take a dose of 2.5 ml orally two times daily
For 2 to 5 years old:
Take a dose of 2.5 ml orally three times daily
For >5 years old:
Take a dose of 5 ml orally two times daily
above 12 years: 500 mg is given orally once every day for one week
for >12 years old:
Administer 2 inhaled aerosols dose at an interval of minimum 1 to 3 minutes followed by a third inhalation
It is used to treat obstructive lung illnesses like COPD and asthma
It is used to treat the symptoms of lung problems, such as wheezing, dyspnea, and tightness in the chest
The recommended usual dose per day is 400 mg two or three times with a maximum permissible limit is 1200 mg per day
It is used to treat obstructive lung illnesses like COPD and asthma
It is used to treat the symptoms of lung problems, such as wheezing, dyspnea, and tightness in the chest
Lower the dosage compared to the adult dosage to 200 mg twice a day
Dose Adjustments
Limited data is available
Future Trends
A condition of progressive lung disease where it restricts airflow, which causes breathing difficulties is known as COPD.Â
32 million individuals are affected by COPD, and it is the third leading cause of death in the US. COPD arises emphysema and chronic bronchitis that causes breathlessness in progressive lung diseases.Â
Major cause of COPD is prolonged inhalation of pollutants, mainly from smoking.Â
NHIS finds 18 emphysema cases per 1000 persons and 34 chronic bronchitis cases per 1000. Global COPD prevalence is unclear, but it ranges from 7% to 19%.Â
Burden of Obstructive Lung Disease study showed global obstructive lung disease prevalence at 10.1%, men at 11.8% and women at 8.5%.Â
Underdiagnosed disease, patients seek care in late stages, which causes issues with diagnosis and treatment effectiveness.Â
COPD causes chronic changes in large airways, small bronchioles, and lung parenchyma. Â
Airway remodelling is a process characterized by the thickening of airway walls, increased mucus production, and fibrosis, which result in long-term inflammation in the airways.Â
Smoking causes macrophages to release chemicals that destroy respiratory tissue. Second-hand smoke harms lungs, worsens asthma, and raises risk of respiratory infections. Â
Airway responsiveness in smoking patients increases risk of COPD, that occurs accelerated decline in lung function.Â
The absolute mortality rates for US patients aged 25 and older due to COPD were 77.3 deaths per 100,000 males and 56.0 deaths per 100,000 females.Â
It is found that heart disease, depression, underweight are linked to lower health-related quality of life in COPD.Â
COPD affects older adults, mostly diagnosed individuals over 40 years old.Â
Â
Respiratory AssessmentÂ
Chest ExaminationÂ
Peripheral ExaminationÂ
Functional AssessmentÂ
Initial mild symptoms progress to worsen severity and frequency with cough, shortness of breath during exertion.Â
Exposure to irritants, weather changes, or illnesses may trigger symptoms.Â
AsthmaÂ
Congestive Heart FailureÂ
Pulmonary EmbolismÂ
BronchiectasisÂ
The use of Bronchodilator therapy, oxygen therapy and pulmonary rehabilitation is very effective in the treatment of COPD.Â
Supportive care and preventive measures should be considered to improve the overall health and quality of life of patients.Â
Medication with inhaled corticosteroids and Phosphodiesterase-4 (PDE-4) Inhibitors should be given to patients. Â
Appointments with medical physicians and preventing recurrence of disorder is an ongoing life-long effort.Â
Pulmonary Medicine
Patients should stop smoking to prevent further damage to their lungs.Â
Patients should avoid environments with high levels of smoke and always stay inside a smoke-free environment.Â
Patient should stay in adequate conditions with good ventilation, air quality and a clean environment.Â
Education should be given to individuals about cautious with activities that could cause pulmonary disease.Â
Pulmonary Medicine
Ipratropium bromide: It is used with a beta-2 agonist that enhances bronchodilation with 2 to 4 puffs administered every 6 to 8 hours. It has a slow onset and longer duration and is less ideal for as-needed use.Â
Tiotropium: Quaternary ammonium compound causes bronchodilation through M3 receptor inhibition thus they have anticholinergic and antimuscarinic effects.Â
Pulmonary Medicine
Theophylline metabolized by liver enzyme system which affected by age, heart conditions, liver issues. Monitor serum levels to prevent toxicity.Â
Pulmonary Medicine
Roflumilast inhibits PDE-4, which reduces exacerbations and symptoms in severe COPD patients.Â
Pulmonary Medicine
Fluticasone relaxes muscles, reduces inflammation, lowers hyperresponsiveness in airways, inhibiting bronchoconstriction.Â
Pulmonary Medicine
Cefuroxime: It is a second-gen cephalosporin, that binds to penicillin-binding proteins and inhibits transpeptidation for cell wall death.Â
Â
Pulmonary Medicine
Direct bronchoscopy administers bronchodilators for targeted airway relief.Â
Bronchial Thermoplasty: Thermal energy delivered to airway walls reduces smooth muscle mass to improve airflow in patients.Â
Endobronchial stents help manage severe airway blockage from COPD complications by maintaining airway openness and enhancing airflow.Â
Pulmonary Medicine
A detailed family history and physical examination of patient is conducted by healthcare specialist in diagnosis phase to identify signs and symptoms of pulmonary disease.Â
The regular follow-up visits with the physician are required to check the improvement of patients and newly observed complaints.Â
Long-term management phase is a very important phase which involves continuous monitoring, supportive care, and surveillance for late effects of treatment.Â
A condition of progressive lung disease where it restricts airflow, which causes breathing difficulties is known as COPD.Â
32 million individuals are affected by COPD, and it is the third leading cause of death in the US. COPD arises emphysema and chronic bronchitis that causes breathlessness in progressive lung diseases.Â
Major cause of COPD is prolonged inhalation of pollutants, mainly from smoking.Â
NHIS finds 18 emphysema cases per 1000 persons and 34 chronic bronchitis cases per 1000. Global COPD prevalence is unclear, but it ranges from 7% to 19%.Â
Burden of Obstructive Lung Disease study showed global obstructive lung disease prevalence at 10.1%, men at 11.8% and women at 8.5%.Â
Underdiagnosed disease, patients seek care in late stages, which causes issues with diagnosis and treatment effectiveness.Â
COPD causes chronic changes in large airways, small bronchioles, and lung parenchyma. Â
Airway remodelling is a process characterized by the thickening of airway walls, increased mucus production, and fibrosis, which result in long-term inflammation in the airways.Â
Smoking causes macrophages to release chemicals that destroy respiratory tissue. Second-hand smoke harms lungs, worsens asthma, and raises risk of respiratory infections. Â
Airway responsiveness in smoking patients increases risk of COPD, that occurs accelerated decline in lung function.Â
The absolute mortality rates for US patients aged 25 and older due to COPD were 77.3 deaths per 100,000 males and 56.0 deaths per 100,000 females.Â
It is found that heart disease, depression, underweight are linked to lower health-related quality of life in COPD.Â
COPD affects older adults, mostly diagnosed individuals over 40 years old.Â
Â
Respiratory AssessmentÂ
Chest ExaminationÂ
Peripheral ExaminationÂ
Functional AssessmentÂ
Initial mild symptoms progress to worsen severity and frequency with cough, shortness of breath during exertion.Â
Exposure to irritants, weather changes, or illnesses may trigger symptoms.Â
AsthmaÂ
Congestive Heart FailureÂ
Pulmonary EmbolismÂ
BronchiectasisÂ
The use of Bronchodilator therapy, oxygen therapy and pulmonary rehabilitation is very effective in the treatment of COPD.Â
Supportive care and preventive measures should be considered to improve the overall health and quality of life of patients.Â
Medication with inhaled corticosteroids and Phosphodiesterase-4 (PDE-4) Inhibitors should be given to patients. Â
Appointments with medical physicians and preventing recurrence of disorder is an ongoing life-long effort.Â
Pulmonary Medicine
Patients should stop smoking to prevent further damage to their lungs.Â
Patients should avoid environments with high levels of smoke and always stay inside a smoke-free environment.Â
Patient should stay in adequate conditions with good ventilation, air quality and a clean environment.Â
Education should be given to individuals about cautious with activities that could cause pulmonary disease.Â
Pulmonary Medicine
Ipratropium bromide: It is used with a beta-2 agonist that enhances bronchodilation with 2 to 4 puffs administered every 6 to 8 hours. It has a slow onset and longer duration and is less ideal for as-needed use.Â
Tiotropium: Quaternary ammonium compound causes bronchodilation through M3 receptor inhibition thus they have anticholinergic and antimuscarinic effects.Â
Pulmonary Medicine
Theophylline metabolized by liver enzyme system which affected by age, heart conditions, liver issues. Monitor serum levels to prevent toxicity.Â
Pulmonary Medicine
Roflumilast inhibits PDE-4, which reduces exacerbations and symptoms in severe COPD patients.Â
Pulmonary Medicine
Fluticasone relaxes muscles, reduces inflammation, lowers hyperresponsiveness in airways, inhibiting bronchoconstriction.Â
Pulmonary Medicine
Cefuroxime: It is a second-gen cephalosporin, that binds to penicillin-binding proteins and inhibits transpeptidation for cell wall death.Â
Â
Pulmonary Medicine
Direct bronchoscopy administers bronchodilators for targeted airway relief.Â
Bronchial Thermoplasty: Thermal energy delivered to airway walls reduces smooth muscle mass to improve airflow in patients.Â
Endobronchial stents help manage severe airway blockage from COPD complications by maintaining airway openness and enhancing airflow.Â
Pulmonary Medicine
A detailed family history and physical examination of patient is conducted by healthcare specialist in diagnosis phase to identify signs and symptoms of pulmonary disease.Â
The regular follow-up visits with the physician are required to check the improvement of patients and newly observed complaints.Â
Long-term management phase is a very important phase which involves continuous monitoring, supportive care, and surveillance for late effects of treatment.Â
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