Published 14 January 2009, doi:10.1136/bmj.b70
Cite this as: BMJ 2009;338:b70

Endgames

Case report

A woman attending for routine review of her chronic obstructive pulmonary disease

¹ Allergy and Respiratory Research Group, Division of Community Health Sciences: GP Section, University of Edinburgh, Edinburgh EH8 9DX

The first 150 words of the full text of this article appear below.

A 57 year old woman attended for routine review of her chronic obstructive pulmonary disease (COPD) complaining that she had recently been more breathless. She was a postal worker and was finding her daily "walk" delivering mail increasingly difficult. She had seen a locum in the practice a few weeks previously who had changed her salmeterol for a combination inhaler containing 100 µg fluticasone and 25 µg salmeterol. The new treatment had not improved her symptoms, and she was worried about the side effects after reading about steroids on the internet.

Her records showed that she requested her treatment regularly, and the nurse noticed that she had had two courses of antibiotics and steroids for exacerbations since the diagnosis had been confirmed five years ago. At the previous year’s review she had been given a prescription for nicotine replacement to help her stop smoking. Post-bronchodilator spirometry showed a forced expiratory . . . [Full text of this article]

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