Importancia de los síntomas en la EPOC

chronic obstructive pulmonary disease (copd) is a major public health problem, due to its high prevalence. furthermore, the prevalence of copd has increased in the last years. the gold initiative has defined copd as a disease state characterised by airflow limitation that is not fully reversible and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. consequently, demonstration of airflow limitation by means of forced spirometry is mandatory for stablishing the diagnosis of copd. spirometry is also required for the classification of severity and follow-up of patients with copd. since airflow limitation is almost irreversible, evaluation of respiratory symptoms is important in copd management. the main symptoms are dyspnea, cough and sputum production. in many cases, treatment will be aimed to control symptoms and improve quality of life, but without significant improvement in lung function parameters. bronchodilator medications are central to the symptomatic management of copd and inhalation should be the preferred route of administration. conversely to asthma, anticholinergic drugs are, at least, as effective as beta-2 agonists. treatment with inhaled corticosteroids is only appropriate for symptomatic copd patients with a documented spirometric response, or for those with severe disease and repeated exacerbations. new perspectives for treatment exist with the development of a new long-acting inhaled anticholinergic, tiotropium bromide, which provides a potent bronchodilator activity with a single daily dose. this and other new drugs under development will offer new alternatives for treatment of this frequent disease.