A Pilot Study of the Mechanism of Synergism Between FP and Salmeterol in Preventing COPD Exacerbations

Inclusion Criteria: * Males or females \> 50 years of age * Physiologic evidence of COPD defined per ATS guidelines as: cigarette smoking history \>20 pack years, FEV1/FVC \<70% * Patients must have a post-bronchodilator FEV1 \>50% of predicted value at enrollment * Patient must have an O2 saturation measure by pulse oximetry \>90% on RA * Must be able to participate in the study, willing to give informed consent, and comply with the study restrictions Exclusion Criteria: * Women of child-bearing potential defined as females who are less than 5 years post menopausal unless they have had a hysterectomy or bilateral oophorectomy * Observation of any solitary nodule in the lung requiring further medical intervention * Patients on maintenance therapy with oral steroids * Patients with giant bullous disease * Significant other medical conditions, which in the opinion of the investigator, will interfere with the patient's ability to perform the study tests * Presence of a coagulopathy as defined by a platelet count \<100,000/mm3, and PT and PTT \>1.2 x the upper limit of normal * Concurrent enrollment or participation in any other clinical trials within the past 30 days * Primary diagnosis of asthma * History of alpha 1 antitrypsin deficiency * Any clinically significant and active pulmonary disease that could contribute to dyspnea * Current systemic and inhaled steroids and theophylline