Abstract
The management of patients with chronic obstructive pulmonary disease (COPD) is often complex but may be conceptualized into three steps. Step 1 entails smoking cessation and preventive vaccinations. Step 2 utilizes bronchodilators (anticholinergics, beta-adrenergic agonists, and methylxanthines). Step 3 employs corticosteroids. To these steps, adjunctive therapy may be added. Although the management of patients with COPD must be individualized, a stepwise approach offers a convenient guide and checklist for clinicians involved in a disease management approach to patient care.