Pt. with severe copd and is non - responsive to inhaled steroids. has tried "most" of the inhaled albuterols, combivents, (albuterol and ipratropium) and anti-cholinergis. ?

Severe COPD should: Be closely managed by a pulmonary specialist.They are experts in managing all the different medicines and ups and downs of this serious condition. Good luck.

Wrong diagnosis?: If you never smoked and aren't responding to these medications the diagnosis may be incorrect. There are a variety of combination meds that are usually effective for true copd; however some people just don't seem to benefit from them. Trying nebulizer medications may be be a good alternative.

See below: I would recommend discussing this with your pulmonologist or if you need a second opinion, find someone on here that has a UT license and discuss it with them. It's possible you aren't on the right medication or maybe have a different diagnosis.