Exacerbations In COPD Patients

In the elderly, COPD is a common chronic condition that affects many patients’ quality of life. It also carries a burden in the United States, with a total cost of $29.5 billion in 2010.1 Accordingly, exacerbations could be a major contribution to the excess cost. An association between rates of COPD exacerbations and the use of cholinesterase inhibitors was researched in a report entitled “COPD Exacerbation and Cholinesterase Therapy in Dementia Patients.” Thus, the rate of exacerbations in COPD patients could theoretically be reduced by measuring the risk-versus-benefit ratio of using cholinesterase inhibitors for concomitant Alzheimer’s disease. In the lungs, acetylcholine is involved in the regulation of bronchoconstriction, mucous production and inflammation.1 Hence, the use of anticholinergics in COPD enhances lung function by decreasing mucous production and inflammation. However, in patients with Alzheimer’s disease, increasing the amount of acetylcholine in the brain is known to be beneficial, which contradicts the therapy used in patients with COPD. Therefore, this poses a challenge in patients with both COPD and dementia. It is estimated that 17% of Medicare patients with Alzheimer’s disease also had COPD. A study was conducted to determine if there …show more content…
In previous studies, they found no correlation between these two variables; however, the studies were for a shorter period of time.1 Since the study was conducted over the first 90 days after initiating cholinesterase inhibitor therapy, it allowed the patients to titrate their baseline doses up to a tolerable and effective dose. This proposes an idea that the higher doses of cholinesterase inhibitors and length of time on these agents could be contributing to the higher risk of COPD