But quitting smoking isn't easy. And this task may seem particularly daunting if you've tried to quit and have been unsuccessful. Talk to your doctor about nicotine replacement products and medications that might help, as well as how to handle relapses.
Your doctor may also recommend a support group for people who want to quit smoking. Also, avoid secondhand smoke exposure whenever possible. Several kinds of medications are used to treat the symptoms and complications of COPD.
You may take some medications on a regular basis and others as needed. Bronchodilators are medications that usually come in inhalers — they relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day or both.
Inhaled corticosteroid medications can reduce airway inflammation and help prevent exacerbations. Side effects may include bruising, oral infections and hoarseness. These medications are useful for people with frequent exacerbations of COPD. Examples of inhaled steroids include:. Some medications combine bronchodilators and inhaled steroids.
Examples of these combination inhalers include:. Combination inhalers that include more than one type of bronchodilator also are available. Examples of these include:. For people who experience periods when their COPD becomes more severe, called moderate or severe acute exacerbation, short courses for example, five days of oral corticosteroids may prevent further worsening of COPD. However, long-term use of these medications can have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and an increased risk of infection.
A medication approved for people with severe COPD and symptoms of chronic bronchitis is roflumilast Daliresp , a phosphodiesterase-4 inhibitor. This drug decreases airway inflammation and relaxes the airways. Common side effects include diarrhea and weight loss.
When other treatment has been ineffective or if cost is a factor, theophylline Elixophyllin, Theo, Theochron , a less expensive medication, may help improve breathing and prevent episodes of worsening COPD. Side effects are dose related and may include nausea, headache, fast heartbeat and tremor, so tests are used to monitor blood levels of the medication.
Respiratory infections, such as acute bronchitis, pneumonia and influenza, can aggravate COPD symptoms. Antibiotics help treat episodes of worsening COPD , but they aren't generally recommended for prevention. Some studies show that certain antibiotics, such as azithromycin Zithromax , prevent episodes of worsening COPD , but side effects and antibiotic resistance may limit their use.
Doctors often use these additional therapies for people with moderate or severe COPD :. Oxygen therapy. If there isn't enough oxygen in your blood, you may need supplemental oxygen. There are several devices that deliver oxygen to your lungs, including lightweight, portable units that you can take with you to run errands and get around town. Some people with COPD use oxygen only during activities or while sleeping.
Others use oxygen all the time. Oxygen therapy can improve quality of life and is the only COPD therapy proved to extend life. Talk to your doctor about your needs and options.
A variety of medicines are used to treat COPD and there is no "best" medicine for all people. Each person's COPD is different and your doctor and healthcare team will work with you to set up the best plan to address your symptoms and needs. Learn more about your treatment options ». If you or someone you love suffers from a chronic lung disease like COPD, there is hope for rebuilding strength and enjoying a fuller, more active life.
Pulmonary rehabilitation programs typically combine education, exercise training, nutrition advice and counseling. Get answers to common questions about pulmonary rehabilitation ». Your body needs oxygen to do everything from digesting food, daily household chores, to going to the grocery store. Sometimes with COPD, you require extra or supplemental oxygen also called oxygen therapy. Learn how supplemental oxygen works and get safety tips ». Some people with very severe COPD symptoms may have a hard time breathing all of the time.
In some of these cases, doctors may suggest lung surgery to improve breathing. Not everyone is a candidate for lung surgery.
Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med.
Diagnosis of chronic obstructive pulmonary disease. Am Fam Physician. Barreiro TJ, Perillo I. An approach to interpreting spirometry. Respir Res. Assessing health status in COPD. BMC Pulm Med. The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. Br Med J. Susceptibility to exacerbation in chronic obstructive pulmonary disease.
Lung function impairment, COPD hospitalisations and subsequent mortality. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. Promoting smoking cessation. Influenza vaccine for patients with chronic obstructive pulmonary disease.
Cochrane Database Syst Rev. Injectable vaccines for preventing pneumococcal infection in patients with chronic obstructive pulmonary disease. Pulmonary rehabilitation in the treatment of chronic obstructive pulmonary disease.
Short-acting beta 2 agonists for stable chronic obstructive pulmonary disease Cochrane Database Syst Rev. Ipratropium bromide versus short acting beta-2 agonists for stable chronic obstructive pulmonary disease Cochrane Database Syst Rev.
In chronic obstructive pulmonary disease, a combination of ipratropium and albuterol is more effective than either agent alone. An day multicenter trial. Inhaled tiotropium for stable chronic obstructive pulmonary disease Cochrane Database Syst Rev. An evaluation of salmeterol in the treatment of chronic obstructive pulmonary disease COPD [published correction appears in Eur Respir J.
Eur Respir J. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. Clin Ther. Tiotropium versus long-acting beta-agonists for stable chronic obstructive pulmonary disease Cochrane Database Syst Rev. Tiotropium in combination with placebo, salmeterol, or fluticasone-salmeterol for treatment of chronic obstructive pulmonary disease: a randomized trial.
Comparison of tiotropium once daily, formoterol twice daily and both combined once daily in patients with COPD. Inhaled anticholinergics and risk of major adverse cardiovascular events in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis [published correction appears in JAMA.
Cardiovascular events associated with ipratropium bromide in COPD. Medications for COPD: a review of effectiveness. Efficacy of theophylline in people with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis. Respir Med. Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials [published correction appears in Lancet. Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials.
Long-term erythromycin therapy is associated with decreased chronic obstructive pulmonary disease exacerbations. Oral corticosteroids for stable chronic obstructive pulmonary disease Cochrane Database Syst Rev. Short-term ambulatory oxygen for chronic obstructive pulmonary disease Cochrane Database Syst Rev. Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial.
National Emphysema Treatment Trial redux: accentuating the positive. J Thorac Cardiovasc Surg. Patients at high risk of death after lung-volume-reduction surgery. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.
Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Nov 15, Issue. This version of the article contains supplemental content. Author disclosure: No relevant financial affiliations. Abstract Diagnosis Assessment Treatment References.
C 14 , 15 Patients in GOLD group A should be treated with a short-acting anticholinergic or short-acting beta 2 agonist on an as-needed basis. A 19 — 21 Patients in GOLD group B should be treated with a long-acting anticholinergic or long-acting beta 2 agonist. Some people with COPD will benefit from ambulatory oxygen, which is oxygen you use when you walk or are active in other ways.
If your blood oxygen levels are normal while you're resting but fall when you exercise, you may be able to have ambulatory oxygen therapy rather than long-term oxygen therapy. If you're taken to hospital because of a bad flare-up, you may have a treatment called non-invasive ventilation NIV.
This is where a portable machine connected to a mask that covers your nose or face is used to support your lungs and make breathing easier. Surgery is usually only suitable for a small number of people with severe COPD whose symptoms are not controlled with medicine.
These are major operations done under general anaesthetic , where you're asleep, and involve significant risks. If your doctors feel surgery is an option for you, speak to them about what the procedure involves and what the benefits and risks are.
Page last reviewed: 20 September Next review due: 20 September Treatments include: stopping smoking — if you have COPD and you smoke, this is the most important thing you can do inhalers and tablets — to help make breathing easier pulmonary rehabilitation — a specialised programme of exercise and education surgery or a lung transplant — although this is only an option for a very small number of people A doctor will discuss the various treatment options with you.
The main types include: Short-acting bronchodilator inhalers For most people with COPD, short-acting bronchodilator inhalers are the first treatment used. There are 2 types of short-acting bronchodilator inhaler: beta-2 agonist inhalers — such as salbutamol and terbutaline antimuscarinic inhalers — such as ipratropium Short-acting inhalers should be used when you feel breathless, up to a maximum of 4 times a day.
Long-acting bronchodilator inhalers If you experience symptoms regularly throughout the day, a long-acting bronchodilator inhaler will be recommended. There are 2 types of long-acting bronchodilator inhaler: beta-2 agonist inhalers — such as salmeterol, formoterol and indacaterol antimuscarinic inhalers — such as tiotropium, glycopyronium and aclidinium Some new inhalers contain a combination of a long-acting beta-2 agonist and antimuscarinic.
Steroid inhalers If you're still becoming breathless when using a long-acting inhaler, or you have frequent flare-ups exacerbations , a GP may suggest including a steroid inhaler as part of your treatment. Tablets If your symptoms are not controlled with inhalers, a doctor may recommend taking tablets or capsules as well.
Theophylline tablets Theophylline is a type of bronchodilator. Possible side effects include: feeling and being sick headaches difficulty sleeping insomnia noticeable pounding, fluttering or irregular heartbeats palpitations Sometimes a similar medicine called aminophylline is also used. Mucolytics If you have a persistent chesty cough with lots of thick phlegm, the doctor may recommend taking a mucolytic medicine called carbocisteine. Steroid tablets If you have a particularly bad flare-up, you may be prescribed a short course of steroid tablets to reduce the inflammation in your airways.
A 5-day course of treatment is usually recommended, as long-term use of steroid tablets can cause troublesome side effects such as: weight gain mood swings weakened bones osteoporosis Your doctor may give you a supply of steroid tablets to keep at home to take as soon as you experience a bad flare-up. Pulmonary rehabilitation Pulmonary rehabilitation is a specialised programme of exercise and education designed to help people with lung problems such as COPD.
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