Stage II, Moderate COPD Treatment Guidelines

Senior man about to use an inhaler
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Chronic obstructive pulmonary disease (COPD) is classified into four stages according to its severity, with moderate COPD considered Stage II of the disease. If you have been diagnosed with moderate COPD, then according to the Global Initiative for Obstructive Lung Disease (GOLD), your FEV1 to FEV ratio -- as measured by a simple lung test known as spirometry -- should be less than 70%; and your FEV1 should be between 50% and 79% of the predicted values for a healthy population.

If you've reached Stage II, you are probably just noticing your symptoms -- primarily shortness of breath that worsens with activity. You may also start noticing that you are coughing more, and have more mucus than you usually do.

You may be wondering if Stage II moderate COPD is treated any differently from other stages. Luckily, GOLD has treatment guidelines for every stage of COPD and as your disease progresses, treatment options will be added in an effort to better manage your symptoms. Listed below are the recommended treatment guidelines for Stage II, moderate COPD:

Smoking Cessation

Why quit smoking if you already have COPD? Smoking cessation is the number one goal of treatment, no matter how far along you are in the disease process. Quitting at this stage can dramatically slow the progression of COPD allowing you to live a higher quality of life and live longer. In addition, there are many other health benefits to quitting.

Flu and Pneumonia Vaccines

GOLD Guidelines recommend flu and pneumonia vaccines for every stage of COPD treatment. Flu shots help decrease your risk of COPD exacerbation, while the pneumonia vaccine helps you prevent bacterial pneumonia, a common cause of COPD exacerbation.

Short-Acting Bronchodilators As Needed

Short-acting bronchodilators are commonly referred to as rescue inhalers. Medications such as Albuterol and Proventil are recommended on an as-needed basis to manage persistent or worsening COPD symptoms.

One or More Long-Acting Bronchodilators

Long-acting bronchodilators are meant to help people with COPD prevent or reduce symptoms. These medications are generally added to treatment once you reach Stage II, moderate COPD. According to GOLD, combining bronchodilators with different modes of action may be more effective than using just one bronchodilator alone, with equal of fewer side effects. Listed below are some examples:

Long-Acting Beta Agonists

Long-Acting Anticholinergics

Pulmonary Rehabilitation

Pulmonary rehabilitation utilizes the entire health care team to target different areas of your treatment. Studies show that pulmonary rehab helps reduce symptoms, improves the quality of life, decreases social isolation and increases survival. The program generally consists of a winning combination of exercise training, nutritionists, education and counseling to help reach its goals.

Don't Forget to Eat Right

Healthy nutrition is often overlooked when planning a treatment program. A nutritious diet not only helps you look and feel better but, it will give you the extra energy you need to get through your day and breathe easier. Eating healthy foods may also reduce your risk of lung infections, a common cause of COPD exacerbation.


Global Initiative for Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of COPD. Updated 2010.

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