Complete Guide to COPD Treatment

Complete Guide to COPD Treatment

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

That COPD is an irreversible lung disease, speaks loudly for important COPD treatment in slowing the disease progression and improving the quality of life.

While many medications are available to treat COPD, no drug has demonstrated effectiveness in halting the insidious progression of the disease. Rather, the goal of drug therapy at this time is to maintain control of symptoms and prevent COPD exacerbation.

The following details some basic types of COPD treatment that your doctor may use during your therapy:

Quitting Smoking

In order to prevent or slow the disease progression, smoking cessation is the most essential, and most commonly overlooked, an aspect of COPD treatment.

In previous years, no drug has rendered itself of benefit to those who had a desire to quit smoking. Thankfully, however, this has changed, and medications are now available to assist people who want to quit. Examples are:

  • Nicotine Replacement Therapy - Including gum, inhalers, tablets, patches and nasal spray. These aids help reduce cravings, making it easier to quit.
  • Antidepressant Therapy - Taken alone or with nicotine replacement therapy, drugs used for depression, such as Wellbutrin, can also help you kick the habit.
  • Clonidine - Used primarily to treat high blood pressure, this drug is thought to be helpful in treating nicotine withdrawal symptoms for those trying to quit smoking.

    Counseling and quit smoking support groups may also prove beneficial as an adjunct to medication therapy.

    Antibiotics

    Those who have an infection associated with COPD are commonly treated with antimicrobials, also referred to as antibiotics. Prescribing antibiotics for conditions that are not associated with a bacterial infection, however, is no longer a common practice among health care providers.

    Most doctors will verify a present blood infection or sputum culture. Common antimicrobials that you may see added to your treatment if you have a respiratory infection include:

    • Tetracyclines
    • Ampicillin
    • Amoxicillin
    • Bactrim

    If you have been prescribed a course of antibiotics from your doctor, make sure you take the entire prescription and don't stop just because you are feeling better. Not finishing your prescription can increase the risk of resistance to the infectious organism.

    Bronchodilators

    Drugs in this class relax the airway wall muscles allowing you to breathe better. The following are some common bronchodilators that your doctor may prescribe:

    Corticosteroids

    According to the Global Initiative for Obstructive Lung Disease (GOLD), how corticosteroids manage to stabilize COPD is limited to specific indications due to the risk of potentially dangerous side effects. Oral corticosteroids, on the other hand, are beneficial in managing acute exacerbation of COPD as they shorten recovery time, improve lung function (FEV1), and hypoxemia.

    They may also decrease a possible early relapse, treatment failure and length of hospital stay. The following lists some common corticosteroids that your doctor may prescribe during your treatment for COPD:

    • Flovent
    • Solumedrol
    • Prednisone

    Phosphodiesterase-4 Inhibitors

    More and more, scientists are discovering that inflammation plays a starring role in many chronic illnesses, COPD included. Phosphodiesterase-4 (PDE4) inhibitors reduce inflammation by blocking PDE4, an enzyme that is overproduced in COPD and asthma causing inflammation in the lungs. PDE4s have only recently been approved for treating COPD. They are administered once a day and help reduce COPD exacerbations in patients with chronic bronchitis.

    Aerosol Therapy

    Aerosol therapy is the process of dispensing particles of medication in a fine spray or mist by way of a nebulizer. The medications frequently used during this process are bronchodilators. Nebulized aerosols work by relieving spasms in the lungs, decreasing swelling, and making your secretions easier to cough up.

    Learn how to use a nebulizer for aerosol therapy.

    Pulmonary Rehabilitation

    Pulmonary rehabilitation offers a unique intervention for patients with COPD. It is most beneficial for those who have debilitating symptoms and whose daily activities are impaired due to the disease.

    Through assessment, exercise, education and psychological support, pulmonary rehabilitation can help reduce COPD symptoms, increase participation in daily activities and reduce overall health care costs in the COPD population.

    Using an interdisciplinary approach, your pulmonary rehabilitation team may be composed of specialists in the field of lung health, such as doctors, nurses, respiratory therapists, physical therapists, occupational therapists, and psychologists. They collectively help you cope with the disease by treating all aspects of the disease from a physical, psychological and social standpoint.

    For optimal results, pulmonary rehabilitation should be long enough to produce the maximum benefit without proving burdensome. While it has been observed that some patients show improvement in as little as 10 days, others have participated in the program for as long as 18 months.

    Oxygen Therapy

    Over two decades ago, the Nocturnal Oxygen Therapy Trial Group performed a 19-month study that showed that patients who were on long-term, continuous oxygen therapy showed a significant decrease in mortality rates than those who used oxygen only at night.

    Oxygen therapy not only increases survival rates in patients with COPD, but it may help alleviate symptoms and improve your quality of life.

    Remember, oxygen is a drug and must be prescribed by a physician.

    Flu Shots

    For those with COPD, recent data indicates that flu shots not only reduce the number of hospitalizations and doctor's visits for a patient with COPD, but decreases overall mortality and morbidity rates. Be sure to see your doctor for more information if you have, or at risk for developing COPD.

    Pneumonia Vaccine

    Pneumococcal pneumonia is a lung disease caused by a bacteria known as Streptococcus pneumoniae. A serious, often life-threatening illness, pneumococcal pneumonia kills approximately 1 out of every 20 people who are afflicted with it.

    People with COPD are at greater risk for developing pneumococcal pneumonia as are those with other chronic health conditions.

    It is strongly recommended that you discuss getting vaccinated with your health care provider if you have a chronic health condition like COPD.

    Surgical Intervention

    There are three types of surgery that may be an option for those with end-stage emphysema that is not amenable to treatment and who meet specific requirements.

    These include bullectomy, lung volume reduction surgery and lung transplantation. Are you a candidate for lung surgery? Find out more about surgical intervention for COPD.

    It is not uncommon for your doctor to use a combination of methods in the management of your disease. Your progress will be based on how well you respond to the treatment methods that he or she has imposed. Your doctor will monitor your prescribed treatment closely to see if, and when, adjustments need to be made. If you have questions concerning your treatment for COPD, be sure to ask your doctor.

    Read more about COPD treatment across the stages:

    Sources:

    Faulkner, Michele A. Pharm.D. & Hilleman, Daniel E. Pharm.D. http://www.medscape.com/viewarticle/462704 "Pharmacologic Treatment of Chronic Obstructive Pulmonary Disease: Past, Present, and Future" Pharmacotherapy 2003 23(10): 1300-1315.

    Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2006. Available from: http://www.goldcopd.org.

    Niewoehner DE, Erbland ML, Deupree RH, et al. Effect of Systemic Glucocorticoids on Exacerbations of Chronic Obstructive PUlmonary Disease. New England Journal of Medicine 1999; 340: 1941-7

    Smeltzer, Suzanne C. & Bare, Brenda, G. Brunnuer and Suddarth's Testbook of Medical-Surgical Nursing (8th Edition). Pennsylvania, PA: Lipponcott-Raven Publishers.

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