Breathing Easier with the Right
Treatment and the Right Device for You
You have many therapy options for treating COPD. Your doctor may prescribe one COPD medication or a combination of COPD medications to help you breathe easier. There are also several different kinds of devices that can be used to inhale your COPD medication.
This wide range of options means you have choices to make with your doctor concerning which treatment and which device are best for you. While this may seem like a big responsibility, it's great to have options when treating COPD. It allows you to find a treatment you are comfortable taking, and that helps you breathe easier.
COPD Treatment Options
Bronchodilators
Bronchodilators (bronk-oh-dial-ay-tors) are central to managing symptoms in COPD.5 This type of medication opens up the bronchial tubes and is frequently used to treat symptoms like shortness of breath, cough, wheezing, and chest tightness.1,5 Bronchodilators come in either oral (a pill) or inhaled form. The inhaled form works faster because the medicine goes directly into your lungs instead of going through the digestive system and bloodstream first.13
Types of bronchodilators include:
"Rescue" Medication
Rescue medication is usually the first type of medication prescribed for someone with COPD. It is meant to be used only when needed. Rescue medication includes:5
- Short-acting bronchodilators, which are used for relief of flare-ups (coughing, wheezing, or a sudden shortness of breath) and last a few hours.5 These include short-acting beta2-agonists, or SABA, such as albuterol.14
Maintenance Medication
Maintenance medication is added to a patient's treatment plan when COPD symptoms get worse and can no longer be controlled by rescue medication alone.5 Maintenance medications are meant to be taken every day and help to continuously control symptoms. These medications include:
- Short-acting anticholinergics (ant-eye-call-in-er-jiks), such as ipratropium, which are usually taken four times daily.15
- Long-acting bronchodilators, which provide sustained relief (12 or 24 hours) and are taken once or twice daily. These include:
- Long-acting beta2-agonists, or LABA, such as PERFOROMIST® (formoterol)
- Long-acting anticholinergics like tiotropium
Combinations
Sometimes medicines are combined for convenience. For instance, your doctor might prescribe for you a SABA/ipratropium combination, so you have two short-acting drugs, one typically taken for rescue and one for maintenance, together in one inhaler, to be taken four times a day.16
Note that your doctor might also prescribe two or more separate medications for you to be used in different situations. For instance, even if you are taking a long-acting bronchodilator for maintenance, you will also need a "rescue" inhaler for sudden episodes of difficulty breathing.1
Beta2-agonists and Anticholinergics
Beta2-agonists open the airways by relaxing the muscles around them.5 Anticholinergics work in a similar way by relaxing the airways (muscle and cholinergic nerves) and helping to keep them open.17
Device Options
Bronchodilators can be delivered by several types of devices. Devices are a means of delivering your medication. The device you and your doctor choose can depend on what you prefer, and what allows you to get the right dose. They include:
- Nebulizers
- Handheld inhalers
- Metered dose inhalers (MDIs)
- Dry powder inhalers (DPIs)
A nebulizer is a machine that creates a gentle mist you can inhale without having to take deep breaths. It takes longer to use than an MDI or DPI, but you relax and breathe normally while using it. This way most people receive the recommended dose of medication. MDIs and DPIs are types of handheld inhalers that you can carry around with you. While they are convenient and portable, they also require you to coordinate your breathing and actions. The fact is, many people improperly use their inhalers and therefore may not get a full dose.5,18
Your doctor may consider other options to treat COPD.
Theophylline
Theophylline relaxes muscles around the breathing passages so the breathing tubes can open and you can breathe easier. This medication is also believed to suppress response of the airways to stimuli. Due to its potential for side effects, bronchodilators are usually preferred.5,19
Corticosteroids
Inhaled corticosteroids may reduce the frequency of flare-ups (coughing, wheezing or a sudden shortness of breath). These drugs are recommended for a limited amount of time, as long-term use has been associated with side effects.5
Combination Therapies
Your doctor may recommend a COPD therapy that includes two medications pre-packaged together in one device. For example, an anticholinergic drug and a short-acting beta2-agonist can be taken together in the same device, either with a nebulizer or a metered dose inhaler. A combination of two drugs that work differently and have different durations of action (how long they work) may improve your breathing.5
Oxygen
Oxygen may help people with severe COPD. If you require additional oxygen, your physician will prescribe it and monitor oxygen levels in your blood.
Antibiotics
Antibiotics are only given for infections, such as pneumonia, which may accompany COPD. Antibiotics don't treat COPD.5
Surgery
There are some surgical procedures that can help people with COPD.5
Pulmonary Rehabilitation
Broad-based programs for improving all aspects of life with COPD have been very successful. Pulmonary rehabilitation programs include medical management, exercise, education and nutritional counseling.5
It's important that your symptoms are controlled as well as possible so you can focus on living life to the fullest and not worrying about your breathing. Let your doctor know if you feel you need more relief from your COPD symptoms. Having a conversation with your doctor is the best way to determine whether or not a COPD treatment is working for you, and whether or not you are ready to consider other options. For help making a plan to talk to your doctor about treatment options, click here.
Next topic: Nebulizer Myths and Facts
