Which therapy is used in COPD acute exacerbation to bronchodilate and dry bronchial secretions?

• A. Oxygen therapy alone
• B. Nebulized epinephrine
• C. Oral prednisone
• D. Duo-Nebulizer (Ipratropium Bromide/Albuterol)

Answer: (D)

In COPD exacerbations, the priority is rapid relief of airway obstruction and help with mucus clearance. The best choice for this immediate effect is an inhaled bronchodilator combination delivered by nebulizer, which provides dual action in one treatment.

The DuoNeb combines ipratropium bromide, an anticholinergic that reduces bronchospasm and mucus production, with albuterol, a short-acting beta-agonist that relaxes airway smooth muscle. Together, they widen the airways and improve mucociliary clearance, addressing both airflow and secretions quickly.

Oxygen therapy is essential if the patient is hypoxic, but on its own it does not bronchodilate or dry secretions. Nebulized epinephrine can open airways but is not a standard go-to treatment for COPD exacerbations due to broader systemic effects. Oral prednisone helps reduce inflammation, but it isn’t an immediate bronchodilator and won’t provide rapid drying of secretions.