Muscarinic antagonists, respiratory rehabilitation and exercise tolerance in COPD: a narrative review

Background: Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable lung inflammatory disease in which professionals can provide patients and caregivers with a specific treatment plan consisting of pharmacological and/or exercise therapy. COPD patients usually control exacerbations and maintain functional status through muscarinic antagonists, either long-acting (LAMA) or short-acting (SABA). One of the functional outcomes of a successful treatment is exercise tolerance, also called subjectively perceived effort during exercise, which is the target of Respiratory Rehabilitation provided by Rehabilitation Nurses. The relationship between pharmacological and nursing interventions in COPD is extremely important for the effectiveness of treatments. It is important to understand how they are associated, when they are used and what results can be obtained in disease management. Aim: Synthesize the relationship between rehabilitation nursing interventions and LAMA/SABA use in COPD management. Materials and Methods: Narrative review in MEDLINE, CINAHL and Cochrane databases, in which, through the screening process, a total of 15 studies were selected. Whittemore and Knafl’s method was used. Results and Conclusions: LAMA and LABA should be used in combination, but efficacy on exercise tolerance levels reduces if there’s no respiratory rehabilitation associated. Nurses should provide counseling and patient education to promote therapy adherence and motivate exercise therapy throughout treatment.