A Guide to COPD Treatment

An Overview of Treatment Options From Oxygen Therapy to Lifestyle Changes

Quitting Smoking
No More Butts. Photo © istockphoto.com user Stepan Popov

Chronic obstructive pulmonary disease (COPD) is an irreversible lung disease, one that researchers haven't yet found a way to cure. However, a variety of medications and lifestyle habits can help control symptoms—trouble breathing, wheezing, cough, and the production of mucus, or phlegm—and lower the risk of other diseases that often are associated with COPD, such as emphysema and chronic bronchitis, according to the Mayo Clinic.

Managing COPD also is vital for preventing what's called COPD exacerbation, a flare-up of symptoms in which coughing, wheezing, and shortness of breath become much worse, mucus production increases, and mucus may change in color from clear to yellow, green, tan, or bloody. A COPD exacerbation often is triggered by an infection, can last for several days, and even land you in the hospital, so staying healthy in general is as important in dealing with COPD as treating symptoms, advises the COPD Foundation.​

There's no question learning that you or a loved one has COPD can be frightening, but there are many viable options for managing the symptoms and leading a long, happy, and productive life.

Medications

The drugs used to treat COPD and related health problems fall into two main camps: Medications for managing specific symptoms of the disease and treatments for infections that, if left untreated, could make COPD much worse.

  • Antibiotics. If you come down with a respiratory infection caused by a bacterium, your doctor may prescribe an antibiotic such as ampicillin or amoxicillin (sometimes sold under the brand names Amoxil, Larotid Suspension, and Moxtag). These are penicillin-like medications that work against bacteria but not viruses (in other words, they won't knock out a common cold or the flu). If you're  prescribed a course of antibiotics, it's very important to take the entire prescription, even after you start feeling better. Not finishing the prescription can increase the risk of antibiotic resistance.
  • Bronchodilators. These medications help relax the muscles in the walls of the airways so that it's easier to breathe. The American Lung Association says there are two types of bronchodilators for treating COPD: short-acting bronchodilators that work within 15 or 20 minutes to relieve shortness of breath, such as albuterol (sometimes sold under the brand names Ventolin, Proventil, and Airet); and long-acting bronchodilators that are used to help keep airways open and relaxed for longer periods of time (throughout the night, for example). Bronchodilators often are administered with aerosol therapy, in which the medicine is given in the form of a fine mist through an instrument called a nebulizer.
  • Corticosteroids. During a COPD exacerbation, oral corticosteroids can shorten recovery time, improve lung function, and relieve hypoxemia (low levels of oxygen in the blood). They also may reduce the risk of relapse, prevent treatment failure, and, if a hospital stay is necessary, shorten the amount of time you're there. Some corticosteroids commonly prescribed for COPD include Flovent (fluticasone oral inhalation); Solu-Medrol (methylprednisolone injection); and prednisone (sometimes sold under the brand names Prednisone Intensol, Sterapred, or Sterapred DS).
  • Phosphodiesterase-4 (PDE4) inhibitors. COPD (as well as asthma) can cause an overproduction of an enzyme that increases inflammation in the lungs called PDE4. PDE4 inhibitors, which block this enzyme, are taken once a day and help ease symptoms of COPD exacerbations in people with chronic bronchitis.

Pulmonary Rehabilitation

This interdisciplinary intervention for people with COPD, which includes assessment, exercise, education, and psychological support, is most beneficial for those who have such debilitating symptoms they aren't able to go about their daily activities as usual. With the help of a team of specialists, including doctors, nurses, respiratory therapists, physical therapists, occupational therapists, and psychologists, a person undergoing pulmonary rehabilitation can have less severe symptoms, enjoy a more normal daily life, and even have lower health care costs.

Pulmonary rehabilitation should last long enough to produce the maximum benefit without becoming burdensome. For some people, this can take as few as 10 days, while others may need as many as 18 months to show improvement.

Oxygen Therapy

Depending on a person's individual needs, supplemental oxygen may be necessary 24 hours a day, only at night, or somewhere in between. Someone who's receiving oxygen therapy to treat COPD may have less severe symptoms, a better quality of life, and even live longer. In any event, supplemental oxygen not only increases survival rates in patients with COPD, but it may help alleviate symptoms and improve quality of life. These benefits may well be worth the potential downsides of oxygen therapy: needing to wear a nasal cannula (a set of small tubes that deliver oxygen through the nose into the airways) and deal with oxygen canisters. 

Lifestyle Changes

  • Quit smoking. Kicking the cigarette habit is one of the most important steps you can take to help manage COPD, but it's not always easy. If going cold turkey won't work for you, consider other options for quitting, such as nicotine replacement therapy (using aids such as gum, inhalers, tablets, patches, or nasal sprays to reduce cravings); taking a drug such as the antidepressant Wellbutrin (bupropion) or clonidine, a hypertension drug thought to be helpful in treating nicotine withdrawal symptoms; and counseling or group therapy.
  • Get the pneumonia vaccinePneumococcal pneumonia is a lung disease caused by the bacterium Streptococcus pneumoniae. People with COPD (and many other chronic health conditions) are at an increased risk of developing pneumonia.
  • Don't skip the flu shot. There's data to show that flu shots not only reduce the number of hospitalizations and doctor's visits for a someone with COPD but also lower the risk of sickness and even death. So even if it means taking an extra trip to the local drugstore, where flu shots are routinely offered, it will be well worth it.

Sources:

Aaron P. Milstone. "Use of Azithromycin in the Treatment of Acute Exacerbations of COPD." Int J Chron Obstruct Pulmon Dis. 2008 Dec; 3(4): 515–520.

Jindal, Surinder K. "Long-Term Oxygen Therapy—It Is Still Relevant?"J Thorac Dis. 2017 Mar; 9(3): E266–E268

Mayo Clinic. Diseases and Conditions: COPD

National Institutes of Health. MedlinePlus. "Drugs, Herbs, and Supplements."

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