COPD and chronic asthma might sometimes be difficult to differentiate. As a general rule (though not exclusively), asthma tends to develop earlier in life, while COPD symptoms are slowly progressive and tend to develop in people with history of tobacco smoking or other smoke exposure.
Algorithm for the management of COPD (adapted GOLD guidelines 2013)
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CAT: dyspnoea scale and/or COPD Assessment Tool; mMRC: modified Medical Research Council dyspnoea scale; ICS: Inhaled corticosteroid; LABA: Long-acting b2-agonist; LAMA: Long-acting anticholinergic; PDE4: Phosphodiesterase type 4; prn: As needed ; SABA: Short-acting b2-agonist; SAMA: Short-acting anticholinergic
* Alone or in combination with other 1st recommended and alternative choices
NEW in GOLD 2013:
a. (LAMA+PDE4 inhibitor) or (LABA+PDE4 inhibitor) added as new alternative options in Group C patients
b. PDE4 monotherapy removed as a possible option
c. Triple therapy has been listed among the recommended first choices for a few patients with newly recognised very severe COPD
d. (ICS + LAMA) removed – insufficient evidence to recommend this combination as an alternative choice
See also: The 2011 GOLD classification and the 2013 GOLD updates
Reference: Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013. Available from: http://www.goldcopd.org/ [adapted]. MIMS Ireland Copyright®