A 58-year-old male factory worker scheduled to undergo a left inguinal hernia repair is noted to have a severe chronic cough. Further pulmonary function tests revealed reduction of forced expiratory volume in 1 second (FEV1) and reduction of FEV1/FVC (forced vital capacity) ratio associated with emphysema. Before rescheduling surgery, which of the following would improve residual function?

Ipratropium bromide bronchodilator therapy will frequently improve pulmonary function in patients with COPD. Two to four inhalations every 4-6 hours are prescribed. COPD is due to emphysema (COPD type A) or chronic bronchitis (COPD type B). In the early stages, small airway dysfunction (abnormal closing volume) is found. As the disease proceeds, the FEV1 is reduced, then the FEV1 /FVC ratio (<0.7).