COPD versus asthma

Although there is overlap between these two conditions there are important distinctions to keep in mind when patients are hospitalized. The points below were drawn from a talk given by Prescott Woodruff, MD, MPH at the 17th annual UCSF hospital medicine course.

General differences
As compared to asthma, COPD patients have more structural lung disease, are weaker with more comorbid conditions and are more likely to have bacterial infections when they present with exacerbations.

Oxygen administration
In COPD as opposed to asthma, greater cautions apply with more reliance on ABGs over pulse oximetry.

Corticosteroids
Some nuanced differences but for the most part similar dosing and rationale.

Inhaled bronchodilators
Beta agonists for both. Greater role of ipratropium in COPD but probably also helpful in asthma.

Antibiotics
Generally used for COPD, selectively used for asthma.

NIPPV
Well established for COPD. Patient selection based on blood gases and clinical assessment. Less well established for asthma but may be helpful in some instances.