Chronic Obstructive Pulmonary Disorder (COPD)

Care & Treatment

There are many things you can do to ease symptoms of COPD, slow the rate at which the disease gets worse, prevent infections, and maintain your independence.

Treatment Starts Here: Stop Smoking

If you have COPD, you must stop smoking. This is the best way to slow lung damage. Research has found that kicking the habit actually reduces the risk of dying from COPD, no matter how old you are or the stage of your illness.

There are a number of excellent programs and aids to help you stop smoking that are now available. Your healthcare provider can help you find the best, most effective approach to suit your needs.

Medications that Help

There are medications that allow you to breathe more easily and reduce your symptoms.  Some are taken by mouth and some are inhaled. They include:

Bronchodilators

Drugs like beta agonists (such as albuterol, salbutamol, terbutaline, salmeterol, or formoterol) and anticholinergics (such as ipratropium or tiotropium) relax the muscles around your airways.  This allows the muscles to expand and let more air through. These drugs are inhaled through a nebulizer or inhaler. They can be long or short-acting and are often prescribed together. 

Only 60% of older adults use inhalers correctly.  This is partly because because neurologic, muscular, and arthritic diseases can interfere with the coordination people need to properly use the devices. A tube-like device called a spacer can be placed on the inhaler to help make sure that you are receiving the full dose of the medication. Ask your healthcare provider to observe whether you are using your inhaler correctly.

Steroids

Medications called corticosteroids  help reduce inflammation. (Some common corticosteroids include prednisolone, fluticasone, budesonide, mometasone, and beclomethasone.) These medications reduce the swelling in the walls of your airways and enlarge the inner space, allowing air to flow more freely. They may also slow down lung damage. They are taken in pill or inhaled form.

When you have a sudden worsening of COPD symptoms, your healthcare provider may prescribe a short course of corticosteroids.  In particular, oral corticosteroids should be taken for as short a time as possible. A longer course of treatment doesn’t necessarily improve outcomes. For example, a 5-day course of oral prednisone provides just about the same relief of symptoms and risk of relapse as a 14-day course does. The shorter course of treatment also provides lower exposure to the steroid than a longer one.

Relatively few patients (5%–10%) need prolonged treatment with oral corticosteroids. Those who do must carefully consider the risks of prolonged treatment.  These risks include developing cataracts, diabetes, osteoporosis, and infections. Patients receiving prolonged treatment should take appropriate preventive measures. For example, using supplemental vitamin D and calcium in order to reduce the risk of osteoporosis.

Oxygen Therapy

There are several ways to get extra oxygen if the oxygen levels in your blood are low. Oxygen supplements can allow you to exercise more, to do more activities at home or when you go out, and feel more comfortable carrying out your daily routine. Researchers have found that if you already had very low blood oxygen levels to start with, your survival time is improved by breathing extra oxygen for 16 hours or more each day.

If your blood oxygen levels are low, you can get extra oxygen in multiple ways.  One is from an oxygen tank.  An oxygen tank can supply oxygen for many hours. You can also use an oxygen concentrator.  An oxygen concentrator is lightweight, easy to move around, and has no tank, but it can only last a few hours. For either device, the oxygen is delivered either through a face mask, or by tubes (called nasal cannula) that fit comfortably in your nose.  

Respiratory (Pulmonary) Rehabilitation

Programs have been developed that help train you to breathe more easily and give you more energy. Other benefits include a feeling of being more in control of your disease and your emotions.

Ask your healthcare provider to recommend a program that is right for you.  These programs can be done at home or in a rehabilitation center, healthcare provider’s office, or a clinic.  A typical program will last about six weeks, for several hours per week.

Pulmonary rehabilitation includes:

  • Physical exercises
  • Breathing exercises and techniques
  • Counseling
  • Education in disease management
  • Nutritional guidance
  • Training in the most energy efficient ways to function in your daily routine 

Recent studies have shown that receiving rehabilitation during a flare-up of COPD symptoms can reduce the likelihood of being admitted to the hospital.

Vaccinations

You should get an annual flu shot as well as a vaccination against pneumonia (pneumococcal vaccine). These will reduce the chances that a serious lung infection will cause a severe COPD flare-up.

Surgery

For a few people, surgery may be helpful. Removing badly damaged lung tissue may allow more healthy parts of your lungs to function better, or to expand and replace the parts that have been removed.

A lung transplant may be an option in some cases, especially for younger COPD patients who can safely undergo this surgery.

 

Last Updated October 2017