COPD Treatment

COPD TreatmentCOPD treatment should include a multifactorial disease management strategy that actively involves the patient in his own care. This strategy should include patient education regarding COPD Symptoms, treatments and the importance of regular follow up with a physician.

First and Foremost, STOP SMOKING! This is absolute the best COPD treatment! In nearly every case, smoking is the cause of COPD. Smoking cessation is the single most important factor in decreasing serious illness and death from COPD. Many medications are available to assist with smoking cessation. Education regarding smoking cessation is also critical to the long-term success of patients with any stage of COPD. Below are the most common treatment strategies.

Medications

In general, COPD treatment involves medical therapy in addition to lifestyle changes. The following list provides a general overview of the medications available to treat COPD.

Beta2-Adrenergic Agonists

• Cause airway dilation to allow increased airflow into and out of the lungs
• Come in short-acting and long-acting forms for acute exacerbation treatment and long-term bronchospasm prevention, respectively
• Examples of short-acting include Albuterol and Xopenex (Levalbuterol)
• Examples of long-acting include Serevent (Salmeterol), Foradil (Formoterol), and Brovana (Arformoterol)

Anticholinergics

• Also cause airway dilation to allow increased airflow into and out of the lungs
• Examples include Atrovent (Ipratropium), Spiriva (Tiotropium), and Tudorza Pressair (Aclidinium)

Xanthine Derivatives

• Cause both airway dilation and pulmonary blood vessel dilation allowing increased oxygenation of blood within the lungs
• Theophylline is the generic name of this drug and comes in several brand names including Aminophylline, Theo-24, Theo-Dur, and Slo-bid

Phosphodiesterase-4 Inhibitors

• These medications decrease exacerbations, decrease shortness of breath, and improve lung function in COPD patients through a currently unclear mechanism
• The available medication in this class is Daliresp (Roflumilast)

Inhaled Corticosteroids

• Inhaled corticosteroids cause airway dilation and decrease inflammation within the lungs
• Both of these effects improve airflow within the lungs and decrease the symptoms of COPD
• Inhaled corticosteroids may also slow the progression of COPD, especially in patients whose disease is rapidly progressing
• Examples include Flovent (Fluticasone inhaled) and Budesonide inhaled

Oral Corticosteroids

• Oral steroids decrease airway inflammation and are highly effective at treating acute COPD exacerbations
• Due to the high incidence of side effects from oral steroids, they are not used long-term for treatment of COPD, even at low doses
• Examples include Prednisone and Methylprednisolone (Solu-medrol, Medrol)

Antibiotics

• Antibiotics are also used in the treatment of acute COPD exacerbations
• Individuals with COPD commonly have chronic infections with certain bacteria and antibiotic therapy improves recovery from acute exacerbations
• They are NOT indicated as a long-term therapy in patients with COPD

Several combination medications are available to increase the ease of medical therapy for COPD. Examples of these combination medications include Combivent or Duoneb (Ipratropium and Albuterol), Symbicort (Budesonide and Formoterol), and Advair Diskus (Fluticasone and Salmeterol).

Please consult your physician to determine which medications are most appropriate for treating your COPD.

Several surgical options are also available for patients generally with very advanced COPD and for whom medications are no longer effective. Please consult your physician if you feel as though surgery may be a necessary treatment option for you. 

COPD Prognosis

COPD is the 4th leading cause of death in the United States! Unfortunately, COPD cannot be cured. It can only be treated. Thus, an individual’s COPD prognosis is based on how effectively his disease can be managed.

Rates of survival are based on several factors, including an individual’s body mass index (BMI), level of airway obstruction, shortness of breath at various levels of activity, and 6-minute walking distance. The better an individual rates in each of these activities, the better his prognosis is for long-term survival.

Please consult your physician to review each of these factors in detail and to determine your COPD prognosis. He or she can also help determine how to improve any individual factor he or she deems necessary.