What is the first-line treatment for a COPD exacerbation?

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The first-line treatment for a COPD exacerbation is bronchodilators and corticosteroids. This approach is effective because exacerbations are often caused by airway inflammation and bronchoconstriction.

Bronchodilators, particularly short-acting beta-agonists such as albuterol, relieve respiratory distress by relaxing the airway muscles, leading to improved airflow and decreased shortness of breath. The addition of corticosteroids (such as prednisolone) helps to reduce inflammation within the airways, which is crucial during an exacerbation to restore normal function and prevent further deterioration.

Using both bronchodilators and corticosteroids in tandem maximizes therapeutic effects and addresses the underlying pathophysiology of COPD exacerbations, making them essential components of acute management.

In contrast, while supplemental oxygen may be necessary for some patients, it alone does not treat the underlying issues contributing to the exacerbation. Oral steroids are part of the treatment but should not be considered alone without bronchodilators for symptom management. Antibiotics might be warranted in the case of bacterial infections leading to exacerbations, but they are not universally necessary, and long-acting beta-agonists are more about maintenance therapy rather than immediate treatment during an acute exacerbation.

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