Pharmacologic management of obstructive lung disease. Current perspectives.

Pharmacotherapy of obstructive lung disease has improved both quantitatively and qualitatively in recent decades: quantitatively with improvements in adrenergic and methylxanthine drugs and qualitatively with the addition of new classes of drugs, such as steroids, cromolyn, and, most recently, anticholinergic agents. Management of airways disease is based upon several principles: near-normal airways function should be aimed for; long-term, systemic, moderate-to-high-dose corticosteroids should be avoided if at all possible; the judicious use of polypharmacy should be undertaken whenever necessary to provide effective treatment while minimizing drug side effects; and the therapeutic program for a given individual should be tailored to that patient's specific responses to various treatments. Available pharmacologic agents have varying efficacies and adverse effects. The various agents may be used in a number of combinations.