Chronic obstructive pulmonary disease (COPD) is the fourth largest cause of worldwide mortality.  Presence of comorbidities is registered in 96% of COPD patients. The most important of these are cardiovascular diseases (coronary artery disease, arterial hypertension, chronic heart failure), which contribute to COPD patients’ mortality in every third case. COPD and cardiovascular diseases have common risk factors and pathogenesis mechanisms. Cardioselective beta-blockers reduce morbidity risk and frequency of COPD exacerbation, are effective and safe in treatment of COPD patients.

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The purpose of the article is to determine the place of the combined bronchodilator fenoterol + ipratropium bromide in the treatment of exacerbations of bronchial asthma, COPD and recommendations on various delivery methods. The treatment of exacerbations of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) is of interest to a general practitioner. Although this concept has lost most of its gloomy colors in the last decade thanks to the new concept of diagnosing and treating patients, the problem of providing qualified timely assistance at the time of an exacerbation remains acute and not always solvable. Often the basis for the treatment of exacerbation of asthma and COPD is repeated administration of a fast-acting inhaled short-acting b2-agonist or an anticholinergic drug, or their combination, early administration of systemic corticosteroids and oxygen inhalation. Exacerbation therapy should be as safe as possible for patients. Following the recommendations for the treatment of asthma and COPD exacerbations both on an outpatient basis and in a hospital can significantly reduce the frequency of asthma and COPD exacerbations. Medical care that a patient can receive at home depends on the experience of the physician and the patient, as well as on the possibilities of medicine and instrumental provision. Ideally, the level of peak expiratory flow (PEF) should be a measure of control over one’s well-being, both in remission and in an exacerbation.

A case of the treatment of a patients with idiopathic pulmonary fibrosis with pirfenidone and nintedanib is reported with reference to the role of these medications in therapy of his condition in the context of modern theory of its pathogenesis.