Medical management of COPD begins with an awareness of risk factors. and identification of at-risk patients. Once disease is identified, patient and family education, a smoking cessation program, and an appropriate bronchodilator regimen should he initiated. Airway secretions and infections should be minimized, hypoxemia corrected, and other secondary physiologic disturbances evaluated when appropriate. Participation in a comprehensive pulmonary rehabilitation program can markedly improve symptoms, function, exercise performance, and quality of life. The results are a reduction in patient limitations, medical expenses, and dependence on medical facilities and caregivers.