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Vol. 46. Issue S8.
EPOC: ¿cómo mejorar la atención al paciente?
Pages 25-30 (November 2010)
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Vol. 46. Issue S8.
EPOC: ¿cómo mejorar la atención al paciente?
Pages 25-30 (November 2010)
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Triple terapia en el tratamiento de la EPOC
Triple therapy in chronic obstructive pulmonary disease
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Adolfo Baloira
Servicio de Neumología. Complejo Hospitalario de Pontevedra, Pontevedra, España
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La enfermedad pulmonar obstructiva crónica (EPOC) es una de las afecciones más importantes en el ámbito respiratorio. Se trata de una enfermedad compleja multicomponente, con inflamación crónica, aumento de las resistencias en las vías aéreas y agudizaciones. Actualmente, disponemos de diversos fármacos para su tratamiento que actúan en dianas diferentes. Los broncodilatadores, sobre todo de acción prolongada, son los más potentes, de los cuales hay dos grupos: beta-2 miméticos y anticolinérgicos. Los corticoides inhalados son los principales antiinflamatorios, aunque su eficacia es modesta y se reservan para pacientes graves con exacerbaciones frecuentes y/o rasgos asmáticos. La posibilidad de asociar estos tres fármacos puede contribuir a un control mayor de los síntomas y mejorar la calidad de vida, así como también a una disminución de las agudizaciones. En este artículo se revisan las evidencias que sostienen esta triple combinación, así como los estudios publicados.

Palabras clave:
Triple terapia
Tiotropio
Budesónida-formoterol
Fluticasona-salmeterol
Abstract

Chronic obstructive pulmonary disease (COPD) is one of the most important respiratory diseases, characterized by its multicomponent complexity, with chronic inflammation, increased airway resistance and exacerbations. Several drugs are currently available for its treatment, which act on distinct targets. Bronchodilators, especially prolonged-action bronchodilators, are the most potent and there are two groups: beta-2 mimetics and anticholinergics. Inhaled corticosteroids are the main anti-inflammatory drugs but have modest efficacy and their use is reserved for patients with severe disease and frequent exacerbations and/or asthma traits. Associating these three drugs can improve symptom control, improve quality of life and reduce the number of exacerbations. The present article reviews the evidence supporting this triple combination, as well as published studies.

Keywords:
Triple therapy
Tiotropium
Budesonide-formoterol
Fluticasone-salmeterol
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