Algorithm B2: Pharmacotherapy

Patient with COPD exacerbation
Institute Oxygen Therapy (Module B3)
Can patient effectively use a metered dose inhaler (MDI) with spacer? [A] User meter dose inhaler and spacer for inhaled bronchodilators
Use small volume nebulizer (SVN) with inhaled bronchodilators Box 4 to box 6
Administer corticosteroids [B]
Consider other drug therapies/treatments as indicated [C]
Has sputum changed or patient has fever? Consider antibiotics [D]
Has patient's repiratory status improved? [E] Modify treatment. Consider tapering medication [F]
Intensify treatment [G] Continue management, go to Emergency Room Module B1, box 8 or