What is the most appropriate first-line treatment for a patient with acute exacerbation of chronic obstructive pulmonary disease (COPD)?

In the context of an acute exacerbation of chronic obstructive pulmonary disease (COPD), bronchodilators serve as the most appropriate first-line treatment. Bronchodilators work by relaxing the muscles of the airways, thereby improving airflow and facilitating easier breathing. This is particularly important during an exacerbation when patients may experience increased dyspnea and wheezing due to airway inflammation and obstruction.

The immediate goal in such exacerbations is to alleviate symptoms, and bronchodilators, especially short-acting beta-agonists (SABAs) and anticholinergics, are effective in providing rapid relief. By opening the airways, these medications help to stabilize the patient and can lead to significant improvements in their respiratory status.

While other treatments, such as systemic corticosteroids, oxygen therapy, and antibiotics, may play important roles depending on the severity of the exacerbation and the presence of complications, they are not the first-line intervention for symptomatic relief. Corticosteroids can help reduce inflammation and improve lung function, while oxygen therapy is crucial for patients with hypoxemia and antibiotics are targeted towards treating infections, if present. However, the immediate relief of bronchoconstriction is best achieved with bronchodilators. Therefore, they