Optimised Complex Therapy of Chronic Obstructive Pulmonary Disease Exacerbation in Elderly Patients (Review)

Chronic obstructive pulmonary disease (COPD) is one of the most important medical and social problems, as it ranks third among the leading causes of death worldwide. Objective — to optimise the treatment of elderly patients with COPD, GOLD II, group B, using sequential nebuliser delivery of the mucolytic drug acetylcysteine and the respiratory cytoprotector ectoine (ectobrise) against the background of basic therapy. Materials and methods. 60 elderly patients with COPD, group B, were observed. Patients in the control group (n = 30) received complex basic therapy, which included an antibacterial drug — amoxicillin/clavu­lanic acid 1.0 g, 1 tab every 12 hours for 5 days, combined bronchodilator therapy — ipratropium bromide monohydrate 21 μg, with fenoterol hydrobromide 50 μg (Berodual®) inhaled using a metered-dose aerosol inhaler, 1 inhalation 3 times per day for 7 days, and additionally a mucolytic drug — acetylcysteine 200 mg — 3 times per day. The second group — the main one (n = 30) received additionally, in addition to the basic therapy, a nebuliser solution of acetylcysteine ​300 mg (Ingamist®, 3.0 ml) and successively an ectoine solution (Ectobrise®) 2.5 ml 2 times per day. during 7 days. Subsequently, patients were prescribed tiotropium bromide as basic therapy, in addition to a monthly course of nebulised delivery of ectoine solution once a day for 7 days for 6 months.The observation period was 1 year. Results and discussion. Comprehensive treatment of elderly patients with COPD group B using additionally nebuliser delivery of acetylcysteine and ectoine contributes to a faster regression of the main symptoms (shortness of breath, cough), a significant improvement in the indicators of external respiratory function — FEV1, normalisation of the psychosocial and functional state of the patient (according to the Clinical COPD Questionnaire (CCQ), which improves the quality of life of patients, shortens the treatment period and prevents relapses of the disease. Conclusions. Additional use in complex treatment of elderly patients with COPD, nebuliser therapy of acetylcysteine and ectoine helps to improve the quality of patients life and prevents relapses of the disease.