Table of Contents

I. COPD Medications

II. Proper Use of An Inhaler

III. Pulmonary Rehabilitation Programs

IV. Conclusion

If you or a loved one has been diagnosed with Chronic Obstructive Pulmonary Disease (COPD), you know firsthand how challenging it can be to live with this progressive respiratory condition. The good news is that with proper management and treatment, it's possible to improve your quality of life significantly.

This article will explore various aspects of COPD management, including medications, proper use of inhalers, pulmonary rehab programs, and lifestyle changes.

COPD Medications

Living with COPD can be challenging, but relief is possible. With the right COPD medications and treatment plan, you can breathe easier and improve your quality of life.

The main goal of COPD treatment is to take the right medicine at the right time to keep your lungs and breathing as healthy as possible. [1] Your doctor will get to know your specific symptoms and needs and then work with you to find the ideal mix of medications.

Bronchodilator

Bronchodilators work by relaxing the muscles that surround your airways. When those muscles tighten, your airways narrow, making it hard for air to flow through. Two types of bronchodilators are used for COPD: beta-2 agonists and anticholinergics. You may be prescribed more than one to treat COPD. [1]

Beta-2 agonists work by relaxing the tightened muscles around your airways, which makes breathing easier. They are available in both short-acting (SABA) and long-acting (LABA) forms. [1]

• Short-acting beta-agonists (SABA) provide quick relief and start to work within 5 minutes. However, the effects only last 4 to 6 hours. SABAs are used as needed to treat sudden symptoms. Common SABA brands include Ventolin and Bricanyl. 

• Long-acting beta-agonists (LABA) take longer to kick in, but relief lasts 12 to 24 hours. LABAs are used as maintenance medications for people with ongoing COPD symptoms. Common LABA brands include Respimat, Serevent, and Foradil. [1]

Anticholinergics prevent the muscles around your airways from tightening. This helps to keep the airways open and aids in clearing mucus from your lungs. By reducing mucus build-up, anticholinergics make it easier to cough and expel mucus. Like beta-2 agonists, anticholinergics are available in short-acting (SAMA) and long-acting (LAMA) forms. [1]

• Short-acting anticholinergics (SAMA) start working within 20 minutes and last 4 to 6 hours. SAMAs are used as needed for intermittent COPD symptoms. Atrovent is a common SAMA.

• Long-acting anticholinergics (LAMA) take up to 30 minutes to begin working and last 12 to 24 hours. They are used for maintenance in people with persistent COPD symptoms. Spiriva, Seebri, and Incruse are examples of LAMAs. [1]

Anti-Inflammatory

Those with COPD often struggle with inflammation and swelling of the airways. Fortunately, there are medications to help alleviate these symptoms. Anti-inflammatory medications for COPD come in two forms: inhaled corticosteroids and corticosteroid pills. [1]

• Inhaled corticosteroids (ICS) are inhaled directly into the lungs to reduce inflammation, swelling, and mucus production in the airways. They are not used alone for COPD but combined with a long-acting bronchodilator (LABA). ICS can help those with moderate to severe COPD, asthma-COPD overlap syndrome, or high eosinophil counts. Common ICS medications include Pulmicort and Alvesco.

• Corticosteroid pills are typically used for shorter periods, primarily during COPD flare-ups. However, in some cases, they may be prescribed for regular use if inhalers alone are not providing sufficient relief. Prednisone is one example of a corticosteroid pill that is commonly prescribed for COPD. [1]

Combination Medicine

Some patients with COPD may need more than one medication to help manage their symptoms. Combining medications can provide more convenience and better relief than using a single inhaler alone. Your doctor might recommend two main approaches: combination therapy or triple therapy. [1]

• Combination therapy combines two different medications in one inhaler or nebulizer treatment. Common combinations include pairing an ICS and LABA, a LAMA and a LABA, or a SABA and a SAMA. Using a combination inhaler ensures you get both medications simultaneously, improving convenience and making it easier to follow your treatment plan.

• Triple therapy is recommended for patients with severe airflow limitation, increased symptoms, high blood eosinophil counts, or a history of COPD exacerbations. These inhalers combine an ICS, a LAMA, and a LABA in one device. An example of this is Trelegy Ellipta. [1]

Proper Use of An Inhaler

Using an inhaler properly is crucial in managing COPD symptoms. Many people don't realize they are misusing their inhalers, so the medication never reaches the lungs where it's needed most. [2] The good news is that with a bit of practice, you can master the proper inhaler technique.

Meter Dose Inhalers (MDIs)

Meter dose inhalers, also known as aerosol inhalers, are the most common type of inhaler you may come across. These inhalers consist of a canister filled with medication, surrounded by a propellant. Pressing down on the canister releases a measured dose of medication while you breathe in. [2]

Some well-known examples of meter dose inhalers include:

• Ventolin
• Flovent
• Advair
• Alvesco [2]

To ensure you are using your meter dose inhaler correctly, follow these simple steps:

1. Shake the inhaler for 10 seconds
2. Remove the cap from the inhaler
3. Breathe out gently, away from the inhaler
4. Place the inhaler’s mouthpiece in your mouth, ensuring a good seal with your lips
5. Press down on the inhaler canister once and breathe in deeply and steadily
6. Hold your breath for 10 seconds and then breathe out slowly
7. If you require another puff, wait for at least one minute before repeating the previous steps
8. After you’ve finished using your inhaler, rinse your mouth with water and spit it out [3]

Dry Powder Inhalers (DPIs)

Dry powder inhalers (DPIs) offer a unique approach to delivering medication directly to your airways. These inhalers are designed to be breath-actuated, meaning that the medicine is released into your airways when you take a deep, fast breath from the inhaler. However, it's important to note that since DPIs require quick and forceful inhalation, they can be challenging to use during a flare-up for some individuals. [4]

One of the key advantages of DPIs is that the medication particles are powdered and incredibly small, allowing them to reach even the tiniest airways in your lungs. It's important to note that DPIs may contain traces of lactose, so individuals with milk allergies should avoid these devices. [4]

Examples of DPIs include:

• Turbuhaler
• Trelegy Ellipta
• Seebri [4]

To ensure you are using your dry powder inhaler correctly, follow these simple steps:

1. Load the medication dose according to the instructions for your specific device
2. Breathe all the way out, away from the inhaler
3. Seal your lips tightly around the mouthpiece
4. Inhale quickly and deeply through your mouth
5. Hold breath for 5 to 10 seconds, then exhale slowly
6. If prescribed 2 doses, reload the medication and repeat the above steps to inhale a second dose [4]

Spacers

If you use an MDI, a spacer can help ensure you get the full benefit of your medication. Spacers are simple tubes that attach to your MDI inhaler and make it easier to take your medication correctly. [2]

When you use an MDI alone, a lot of the medicine can end up in your mouth, throat, or stomach instead of reaching your lungs. A spacer helps guide the medication straight into your airways where it’s needed. Using a spacer is an easy way to boost how much medication is delivered to your lungs with each puff. [2]

To use your MDI with a spacer, follow these steps:

1. Shake the inhaler three to four times
2. Attach the inhaler to the spacer
3. Breathe out fully away from the spacer
4. Close your lips around the mouthpiece of the spacer
5. Press the top of the inhaler once to release a dose into the spacer
6. Breathe in very slowly until you have taken a full breath. If you hear a whistle sound, you are breathing in too fast.
7. Hold your breath for 10 seconds, and then breathe out
8. Wait a minimum of 30 seconds before taking another puff [2]

Pulmonary Rehabilitation Programs

If you’re struggling with COPD, pulmonary rehabilitation programs may help. These programs provide education and exercise in a supportive group setting to help you better manage your lung condition. [5]

By attending pulmonary rehab, you'll learn valuable skills to strengthen your body and improve your breathing. A team of doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dieticians will hold classes which include: [5]

• Education about COD symptoms, medication, and oxygen
• Supervised exercise classes
• Breathing techniques
• Nutritional counseling
• Emotional health support [5]

In these classes, you'll meet other COPD patients who understand what you're going through. A community with similar struggles can provide emotional support and a sense of progress. [5]

With improved fitness, breathing, nutrition, and disease management skills, pulmonary rehab aims to enhance your quality of life. Exercising your lungs regularly helps avoid hospital visits down the road. [5]

Lifestyle Changes

Living with COPD can be challenging but implementing a few key lifestyle changes can make a big difference in managing symptoms and improving quality of life. While COPD has no cure, the following positive steps can help you breathe easier and reduce exacerbations.

• Quit smoking: Tobacco smoke severely damages the lungs and is the leading cause of COPD. By quitting, you can significantly slow further damage to your lungs and decrease symptoms like coughing and shortness of breath.

• Avoid air pollutants: These pollutants can come from various sources, such as dust, pollen, environmental smoke, insecticides, household cleaners, lotions, perfumes, and bug sprays. By minimizing your exposure to these irritants, you can help reduce exacerbations.

• Consult a doctor: Before making any significant lifestyle changes, it’s always advisable to consult with your doctor. They can provide personalized guidance and ensure that modifications align with your circumstances. Additionally, if you find that your current treatment plan is not effectively managing your COPD symptoms, make sure to discuss this with your doctor, as they may need to adjust your treatment approach.

• Avoid the heat: During the summer, when it's humid and hot, some individuals with COPD may have trouble breathing. To minimize discomfort during this time, move quickly from one air-conditioned environment to another. If possible, have someone cool your car before you get in, making the transition more comfortable. [6]

Conclusion

Living with COPD can present daily challenges, but with the right treatment plan, it is possible to manage symptoms and lead a fulfilling life. The key is working closely with your healthcare team to find the combination of therapies that addresses your needs.

To learn more about COPD, visit our dedicated COPD blog for more topics.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.