科研之友
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摘要
A 55-year-old man presents with a history of recurrent exacerbations of chronic obstructive pulmonary disease (COPD) during the past year. These episodes were characterized by increased shortness of breath, cough, and sputum production. The diagnosis of COPD was made 2 years previously. Pulmonary-function testing then revealed a forced expiratory volume in 1 second (FEV1) of 50% of the predicted value after bronchodilator inhalation, with a ratio of FEV1 to forced vital capacity (FVC) of 60%. The patient had a 30-pack-year smoking history but stopped smoking after chronic lung disease was diagnosed. On the current visit, he is afebrile and has a resting pulse of 84 beats per minute. A careful review confirms that he is knowledgeable about proper inhaler use and that he is compliant with his medications, which include maintenance therapy with salmeterol and fluticasone as well as albuterol plus ipratropium as needed for intermittent therapy for increased dyspnea. His physician recommends the use of azithromycin at a dose of 250 mg daily to reduce the frequency of acute exacerbations.
- 出版日期2012-7-26
