COPD in the ambulatory elderly: management update.

Chronic obstructive pulmonary disease (COPD) is made up of at least three entities: asthma, chronic bronchitis, and emphysema. Each has its own unique physiology, pathology, and natural history. These are reviewed, and current therapeutic options are presented, including the first-line therapy of beta 2 agonists, theophylline, and the newer anticholinergic inhalers. The role of steroids, both acute and chronic, the proper use of antibiotics and vaccinations, and the use of home oxygen therapy, pulmonary rehabilitation, and anxiolytics are discussed.