Tratamiento farmacológico y no farmacológico de la enfermedad pulmonar obstructiva crónica
Pharmacologic and non-pharmacologic treatment of chronic obstructive pulmonary disease
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Molina-Franky J, Roa Cubaque MA, Corredor Gamba SP, Polanía Robayo AY, Rojas Laverde M del P. Tratamiento farmacológico y no farmacológico de la enfermedad pulmonar obstructiva crónica. Revista Investig. Salud Univ. Boyacá [Internet]. 3 de septiembre de 2018 [citado 21 de diciembre de 2024];5(2):295-322. Disponible en: https://revistasdigitales.uniboyaca.edu.co/index.php/rs/article/view/345
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Introducción. La enfermedad pulmonar obstructiva crónica (EPOC), caracterizada por limitación del flujo aéreo, constituye una patología con alta prevalencia y mortalidad a nivel mundial, representada por exacerbaciones que requieren escalonar el tratamiento; el abordaje se realiza por medio de medidas farmacológicas y no farmacológicas. Objetivo. Sintetizar los aspectos relevantes de las principales guías de manejo y de los artículos científicos acerca del tratamiento farmacológico y no farmacológico de la enfermedad pulmonar obstructiva crónica. Método. Revisión descriptiva sobre el tratamiento farmacológico y no farmacológico de la enfermedad pulmonar obstructiva crónica, a partir de la búsqueda de literatura publicada en bases de datos electrónicas especializadas en salud. Se encontraron 265 documentos, entre artículos y guías, que cumplían con los criterios de búsqueda, se seleccionaron 118, se excluyeron 60 y se analizaron 58 referencias. Conclusión. La enfermedad pulmonar obstructiva crónica tiene alta prevalencia y mortalidad a nivel mundial, por esto hay que diagnosticarla bajo los parámetros de la guía de referencia mundial Global Initiative for Chronic Obstructive Lung Disease y de acuerdo con esto, abordar al paciente de forma integral e instaurándole un manejo farmacológico y no farmacológico individualizado con el fin de aumentar la adherencia al tratamiento, disminuir los síntomas y las exacerbaciones y, por consiguiente, mejorar la calidad de vida.
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3. Raluy-Callado M, Lambrelli D, MacLachlan S, Khalid JM. Epidemiology, severity, and treatment of chronic obstructive pulmonary disease in the United Kingdom by GOLD 2013. Int J Chron Obstruct Pulmon Dis. 2015;10:925-37. https://doi.org/10.2147/COPD.S82064
4. Farias CC, Resqueti V, Dias FAL, Borghi-Silva A, Arena R, Fregonezi GA de F. Costs and benefits of Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease: a randomized controlled trial. Braz J Phys Ther. 2014;18(2):165-73. http://dx.doi.org/10.1590/S1413-35552012005000151
5. Osthoffa M, Jenkins C, Leuppi JD. Chronic obstructive pulmonary disease-A treatable disease. Swiss Med Wkly. 2013;143:1-8. https://doi.org/10.4414/smw.2013.13777
6. Health O, Assessment T. Chronic obstructive pulmonary disease (COPD) evidentiary framework. Ont Health Technol Assess Ser. 2012;12(2):1-97.
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9. López-Giraldo a, Rodriguez-Roisin R, Agustí A. Enfermedad pulmonar obstructiva crónica. Actualización 2014. Med Balear. 2014;29(1):43-48. https://doi.org/10.3306/MEDICINABALEAR.29.01.43
10. Bello S, Chamorro H, Barrientos A. Tratamiento del tabaquismo en pacientes con enfermedad pulmonar obstructiva crónica. Rev Chil Enf Respir. 2013;29:24-30. http://dx.doi.org/10.4067/S0717-73482013000100004.
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14. Wurst KE, St Laurent S, Mullerova H, Davis KJ. Characteristics of patients with COPD newly prescribed a long-acting bronchodilator: a retrospective cohort study. Int J COPD. 2014;9:1021-1031. https://doi.org/10.2147/COPD.S58258
15. Hizawa N. LAMA/LABA vs ICS/LABA in the treatment of COPD in Japan based on the disease phenotypes. Int J Chron Obstruct Pulmon Dis. 2015;10:1093-1102. https://doi.org/10.2147/COPD.S72858
16. Horhota ST, van Noord JA, Verkleij CB, Bour LJ, Sharma A, Trunk M, et al. In Vitro, Pharmacokinetic, Pharmacodynamic, and Safety Comparisons of Single and Combined Administration of Tiotropium and Salmeterol in COPD Patients Using Different Dry Powder Inhalers. AAPS J. 2015;17(4):871-880. https://doi.org/10.1208/s12248-015-9751-7
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22. Molimard M, Colthorpe P. Inhaler Devices for Chronic Obstructive Pulmonary Disease: Insights from Patients and Healthcare Practitioners. J Aerosol Med Pulm Drug Deliv. 2015;28(3):219-228. https://doi.org/10.1089/jamp.2014.1142
23. Norris V, Ambery C. Bronchodilation and safety of supratherapeutic doses of salbutamol or ipratropium bromide added to single dose GSK961081 in patients with moderate to severe COPD. Pulm Pharmacol Ther. 2013;26(5):574-580. https://doi.org/10.1016/j.pupt.2013.03.009
24. Braido F, Baiardini I, Sumberesi M, Blasi F, Canonica GW. Obstructive lung diseases and inhaler treatment: results from a national public pragmatic survey. Respir Res. 2013;14(1):94. https://doi.org/10.1186/1465-9921-14-94
25. Calzetta L, Rogliani P, Matera MG, Cazzola M. A systematic review with meta-analysis of dual bronchodilation with LAMA/LABA for the treatment of stable chronic obstructive pulmonary disease. Chest. 2016;149 (5):1181-1196. https://doi.org/10.1016/j.chest.2016.02.646.
26. Miravitlles M, Soler-Cataluña JJ, Calle M, Molina J, Almagro P, Quintano JA, et al. Guía Española de la EPOC (GesEPOC). Tratamiento farmacológico de la EPOC estable. Aten Primaria. 2012;44(7):425-37. https://doi.org/10.1016/j.aprim.2012.04.005
27. Tashkin DP, Ferguson GT. Combination bronchodilator therapy in the management of chronic obstructive pulmonary disease. Respir Res. 2013;14(1):49. https://doi.org/10.1186/1465-9921-14-49
28. Lindenauer PK, Shieh M-S, Pekow PS, Stefan MS. Use and Outcomes Associated with Long-acting Bronchodilators among Patients Hospitalized for Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2014;11(8):1186-1194. https://doi.org/10.1513/AnnalsATS.201407-311OC
29. Cazzola M, Page CP, Calzetta L, Matera MG. Pharmacology and Therapeutics of Bronchodilators. Pharmacol Rev. 2012;64(3):450-504. https://doi.org/10.1124/pr.111.004580
30. Tashkin DP, Li N, Kleerup EC, Halpin D, Celli B, Decramer M, et al. Acute bronchodilator responses decline progressively over 4 years in patients with moderate to very severe COPD. Respir Res. 2014;15(1):102. https://doi.org/10.1186/s12931-014-0102-5
31. Magnussen H, Paggiaro P, Schmidt H, Kesten S, Metzdorf N, Maltais F. Effect of combination treatment on lung volumes and exercise endurance time in COPD. Respir Med. 2012;106(10):1413-1420. https://doi.org/10.1016/j.rmed.2012.05.011
32. Menezes A, Macedo S. Pharmacological treatment of COPD. J Bras Pneumol. 2011;37(4):527-43. http://dx.doi.org/10.1590/S1806-37132011000400016
33. Harries TH, Seed PT, Jones S, Schofield P, White P. Chronic obstructive pulmonary disease hospital admissions and drugs--unexpected positive associations: a retrospective general practice cohort study. NPJ Prim Care Respir Med. 2014;24:14006. https://doi.org/10.1038/npjpcrm.2014.6
34. D´Urzo A, Donohue JF, Kardos P, Miravitlles M. A re-evaluation of the role of inhaled corticosteroids in the management of patients with chronic obstructive pulmonary disease. Expert Opin Pharmacother. 2015;16(12):1845-1860. https://doi.org/10.1517/14656566.2015.1067682
35. Oba Y, Lone NA. Comparative efficacy of inhaled corticosteroid and long-acting beta agonist combinations in preventing COPD exacerbations: a bayesian network meta-analysis. Int J COPD. 2014;9:469-479. https://doi.org/10.2147/COPD.S48492
36. Díaz G, Palmeiro G, Valiño M, Robles A et al. Adecuación del tratamiento inhalado en pacientes diagnosticados de enfermedad pulmonar obstructiva crónica. 2013;6(1):4-9. http://dx.doi.org/10.4321/S1699-695X2013000100002
37. Ferreira J, Drummond M, Pires N, Reis G, Alves C, Robalo-Cordeiro C. Optimal treatment sequence in COPD: Can a consensus be found? Rev Port Pneumol. 2016;22(1):39-49. https://doi.org/10.1016/j.rppnen.2015.10.009
38. Brill SE, Wedzicha J a. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014;9(1):1241-1252. https://doi.org/10.2147/COPD.S41476
39. Nishi SPE, Zhang W, Kuo Y-F, Sharma G. Oxygen therapy use in older adults with chronic obstructive pulmonary disease. PloS One. 2015;10(3):e0120684. https://doi.org/10.1371/journal.pone.0120684
40. Lou Peian, Chen Peipei, Zhang Pan, Yu Jiaxi, Wang Young, Chen Na, Zhang Li, Wu Hongmin ZJ. Efficiency and Safety of Pulmonary Rehabilitation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Respir Care. 2015;60:102-12. https://doi.org/10.12659/MSM.892769
41. Arancibia Francisco PJ. Consenso chileno de rehabilitación respiratoria en el paciente con EPOC. Rev Chil Enf Respir. 2011;27:77-79. http://dx.doi.org/10.4067/S0717-73482011000200001
42. Cameron-Tucker HL, Wood-Baker R, Owen C, Joseph L, Walters EH. Chronic disease self-management and exercise in COPD as pulmonary rehabilitation: a randomized controlled trial. Int J Chron Obstruct Pulmon Dis. 2014;9:513-23. https://doi.org/10.2147/COPD.S58478
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2. Ramon MA, Gimeno-Santos E, Ferrer J, Balcells E, Rodríguez E, De Batlle J, et al. Hospital admissions and exercise capacity decline in patients with COPD. Eur Respir J. 2014;43(4):1018-27. https://doi.org/10.1183/09031936.00088313
3. Raluy-Callado M, Lambrelli D, MacLachlan S, Khalid JM. Epidemiology, severity, and treatment of chronic obstructive pulmonary disease in the United Kingdom by GOLD 2013. Int J Chron Obstruct Pulmon Dis. 2015;10:925-37. https://doi.org/10.2147/COPD.S82064
4. Farias CC, Resqueti V, Dias FAL, Borghi-Silva A, Arena R, Fregonezi GA de F. Costs and benefits of Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease: a randomized controlled trial. Braz J Phys Ther. 2014;18(2):165-73. http://dx.doi.org/10.1590/S1413-35552012005000151
5. Osthoffa M, Jenkins C, Leuppi JD. Chronic obstructive pulmonary disease-A treatable disease. Swiss Med Wkly. 2013;143:1-8. https://doi.org/10.4414/smw.2013.13777
6. Health O, Assessment T. Chronic obstructive pulmonary disease (COPD) evidentiary framework. Ont Health Technol Assess Ser. 2012;12(2):1-97.
7. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (Revised 2012). 2012. 90 p.
8. Koul P a, Khan UH, Asad R, Yousuf R, Broor S, Lal RB, et al. Contribution of influenza to acute exacerbations of chronic obstructive pulmonary disease in Kashmir, India, 2010-2012. Influenza Respir Viruses. 2015;9(1):40-42. https://doi.org/10.1111/irv.12291
9. López-Giraldo a, Rodriguez-Roisin R, Agustí A. Enfermedad pulmonar obstructiva crónica. Actualización 2014. Med Balear. 2014;29(1):43-48. https://doi.org/10.3306/MEDICINABALEAR.29.01.43
10. Bello S, Chamorro H, Barrientos A. Tratamiento del tabaquismo en pacientes con enfermedad pulmonar obstructiva crónica. Rev Chil Enf Respir. 2013;29:24-30. http://dx.doi.org/10.4067/S0717-73482013000100004.
11. Londoño D. Guía de práctica clínica basada en la evidencia para la prevención, diagnóstico, tratamiento y seguimiento de la enfermedad pulmonar obstructiva crónica en población adulta. Ministerio de Salud y Protección Social-Colciencias. Minist Protección Soc Colomb. 2014;(28).
12. Secretaría de salud de Boyacá. ASIS BOYACÁ. Tunja; 2011.
13. Polatli M, Bilgin C, Saylan B, Baslilar S, Toprak E, Ergen H, et al. A cross sectional observational study on the influence of chronic obstructive pulmonary disease on activities of daily living: the COPD-Life study. Tuberk Toraks. 2012;60(1):1-12. https://doi.org/10.5578/tt.3414
14. Wurst KE, St Laurent S, Mullerova H, Davis KJ. Characteristics of patients with COPD newly prescribed a long-acting bronchodilator: a retrospective cohort study. Int J COPD. 2014;9:1021-1031. https://doi.org/10.2147/COPD.S58258
15. Hizawa N. LAMA/LABA vs ICS/LABA in the treatment of COPD in Japan based on the disease phenotypes. Int J Chron Obstruct Pulmon Dis. 2015;10:1093-1102. https://doi.org/10.2147/COPD.S72858
16. Horhota ST, van Noord JA, Verkleij CB, Bour LJ, Sharma A, Trunk M, et al. In Vitro, Pharmacokinetic, Pharmacodynamic, and Safety Comparisons of Single and Combined Administration of Tiotropium and Salmeterol in COPD Patients Using Different Dry Powder Inhalers. AAPS J. 2015;17(4):871-880. https://doi.org/10.1208/s12248-015-9751-7
17. Sundh J, Osterlund Efraimsson E, Janson C, Montgomery S, Stallberg B, Lisspers K. Management of COPD exacerbations in primary care: a clinical cohort study. Prim Care Respir J. 2013;22(4):393-9. https://doi.org/10.4104/pcrj.2013.00087
18. Magnussen H, Disse B, Rodriguez-Roisin R, Kirsten A, Watz H, Tetzlaff K, et al. Withdrawal of Inhaled Glucocorticoids and Exacerbations of COPD. N Engl J Med. 2014;371(14):1285-1294. https://doi.org/10.1056/NEJMoa1407154
19. Mehring M, Donnachie E, Fexer J, Hofmann F, Schneider A. Disease management programs for patients with COPD in Germany: A longitudinal evaluation of routinely collected patient records. Respir Care. 2014;59(7):1123-1132. https://doi.org/10.4187/respcare.02748
20. Merino-trujillo A. Como escribir documentos científicos (Parte 3). Artículo de revisión. Salud en Tabasco. 2011;17(1 y 2):36-40.
21. Asociación latinoamericana de tórax. Recomendaciones para el Diagnóstico y Tratamiento de la Enfermedad Pulmonar Obstructiva Crónica (EPOC). 1.a ed. Respirar. 2011. p. 1-43
22. Molimard M, Colthorpe P. Inhaler Devices for Chronic Obstructive Pulmonary Disease: Insights from Patients and Healthcare Practitioners. J Aerosol Med Pulm Drug Deliv. 2015;28(3):219-228. https://doi.org/10.1089/jamp.2014.1142
23. Norris V, Ambery C. Bronchodilation and safety of supratherapeutic doses of salbutamol or ipratropium bromide added to single dose GSK961081 in patients with moderate to severe COPD. Pulm Pharmacol Ther. 2013;26(5):574-580. https://doi.org/10.1016/j.pupt.2013.03.009
24. Braido F, Baiardini I, Sumberesi M, Blasi F, Canonica GW. Obstructive lung diseases and inhaler treatment: results from a national public pragmatic survey. Respir Res. 2013;14(1):94. https://doi.org/10.1186/1465-9921-14-94
25. Calzetta L, Rogliani P, Matera MG, Cazzola M. A systematic review with meta-analysis of dual bronchodilation with LAMA/LABA for the treatment of stable chronic obstructive pulmonary disease. Chest. 2016;149 (5):1181-1196. https://doi.org/10.1016/j.chest.2016.02.646.
26. Miravitlles M, Soler-Cataluña JJ, Calle M, Molina J, Almagro P, Quintano JA, et al. Guía Española de la EPOC (GesEPOC). Tratamiento farmacológico de la EPOC estable. Aten Primaria. 2012;44(7):425-37. https://doi.org/10.1016/j.aprim.2012.04.005
27. Tashkin DP, Ferguson GT. Combination bronchodilator therapy in the management of chronic obstructive pulmonary disease. Respir Res. 2013;14(1):49. https://doi.org/10.1186/1465-9921-14-49
28. Lindenauer PK, Shieh M-S, Pekow PS, Stefan MS. Use and Outcomes Associated with Long-acting Bronchodilators among Patients Hospitalized for Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2014;11(8):1186-1194. https://doi.org/10.1513/AnnalsATS.201407-311OC
29. Cazzola M, Page CP, Calzetta L, Matera MG. Pharmacology and Therapeutics of Bronchodilators. Pharmacol Rev. 2012;64(3):450-504. https://doi.org/10.1124/pr.111.004580
30. Tashkin DP, Li N, Kleerup EC, Halpin D, Celli B, Decramer M, et al. Acute bronchodilator responses decline progressively over 4 years in patients with moderate to very severe COPD. Respir Res. 2014;15(1):102. https://doi.org/10.1186/s12931-014-0102-5
31. Magnussen H, Paggiaro P, Schmidt H, Kesten S, Metzdorf N, Maltais F. Effect of combination treatment on lung volumes and exercise endurance time in COPD. Respir Med. 2012;106(10):1413-1420. https://doi.org/10.1016/j.rmed.2012.05.011
32. Menezes A, Macedo S. Pharmacological treatment of COPD. J Bras Pneumol. 2011;37(4):527-43. http://dx.doi.org/10.1590/S1806-37132011000400016
33. Harries TH, Seed PT, Jones S, Schofield P, White P. Chronic obstructive pulmonary disease hospital admissions and drugs--unexpected positive associations: a retrospective general practice cohort study. NPJ Prim Care Respir Med. 2014;24:14006. https://doi.org/10.1038/npjpcrm.2014.6
34. D´Urzo A, Donohue JF, Kardos P, Miravitlles M. A re-evaluation of the role of inhaled corticosteroids in the management of patients with chronic obstructive pulmonary disease. Expert Opin Pharmacother. 2015;16(12):1845-1860. https://doi.org/10.1517/14656566.2015.1067682
35. Oba Y, Lone NA. Comparative efficacy of inhaled corticosteroid and long-acting beta agonist combinations in preventing COPD exacerbations: a bayesian network meta-analysis. Int J COPD. 2014;9:469-479. https://doi.org/10.2147/COPD.S48492
36. Díaz G, Palmeiro G, Valiño M, Robles A et al. Adecuación del tratamiento inhalado en pacientes diagnosticados de enfermedad pulmonar obstructiva crónica. 2013;6(1):4-9. http://dx.doi.org/10.4321/S1699-695X2013000100002
37. Ferreira J, Drummond M, Pires N, Reis G, Alves C, Robalo-Cordeiro C. Optimal treatment sequence in COPD: Can a consensus be found? Rev Port Pneumol. 2016;22(1):39-49. https://doi.org/10.1016/j.rppnen.2015.10.009
38. Brill SE, Wedzicha J a. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014;9(1):1241-1252. https://doi.org/10.2147/COPD.S41476
39. Nishi SPE, Zhang W, Kuo Y-F, Sharma G. Oxygen therapy use in older adults with chronic obstructive pulmonary disease. PloS One. 2015;10(3):e0120684. https://doi.org/10.1371/journal.pone.0120684
40. Lou Peian, Chen Peipei, Zhang Pan, Yu Jiaxi, Wang Young, Chen Na, Zhang Li, Wu Hongmin ZJ. Efficiency and Safety of Pulmonary Rehabilitation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Respir Care. 2015;60:102-12. https://doi.org/10.12659/MSM.892769
41. Arancibia Francisco PJ. Consenso chileno de rehabilitación respiratoria en el paciente con EPOC. Rev Chil Enf Respir. 2011;27:77-79. http://dx.doi.org/10.4067/S0717-73482011000200001
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