Treatments

COPD is a progressive disease, which means that it gets worse over time. Because there is no cure for COPD, all the currently available treatments concentrate on slowing the disease progression, controlling the symptoms and reducing complications.

Early and continued treatment can reduce the frequency of exacerbations, improve your general health, and make it possible for you to exercise.

General points about treatment

It is vital that you take your medication as your doctor prescribed it and that you tell your doctor about any change in symptoms. Your treatment may be changed if your symptoms become more severe, and there may be times when you are taking several different types of medicine.

Your doctor may have graded your COPD as stage I, II, III or IV, and will have prescribed your treatment according to this grade. As your condition changes, it may be your therapy should change. Only your doctor can determine what type of treatment is appropriate for your COPD. There will be some days when you feel better than others, but if you stop taking the treatment, your symptoms will return, and may be worse than before.

If you are using an inhaler, it is important that you are using it correctly. If you are unsure, you should ask your doctor or your nurse to give you further instructions.

Types of medications

Bronchodilators

Bronchodilators make breathing easier by opening up the airways to the lungs. They are usually taken with an inhaler or similar device, which delivers the drug directly to the lungs. There are many different types of inhalers

Corticosteroids

Corticosteroids are used to help control inflammation. They may be taken either as tablets or inhaled corticosteroids.

Regular inhaled corticosteroid treatment is usually prescribed to people with moderate or severe COPD with frequent exacerbations. There are many types of inhaled steroids but they all have the same effect on reducing inflammation. Tablet or oral steroids are usually recommended for short-term use during exacerbations.

Combination therapies

Combination therapies combining corticosteroids and long-acting beta agonists are available for treatment in COPD. This treatment has been shown to reduce the frequency of exacerbations and improve health status. Studies have also shown that combining corticosteroid treatment with a long-acting beta agonist is more effective than taking the individual components alone.

Combination therapies combining short-acting beta-2 agonists and anticholinergic drugs are also available.

Oxygen therapy

Oxygen therapy is usually only suitable for people with severe COPD.

There are several different methods of giving oxygen. Long-term oxygen therapy is usually given for several hours at a time. The equipment for long-term oxygen therapy is bulky and immobile, and usually only available for use at home. Ambulatory oxygen therapy enables the person with COPD to carry oxygen cylinders around with them, so they are freed from the confines of their own home.

Short-burst oxygen therapy is sometimes recommended for people who become severely breathless after exertion – for instance when they climb the stairs.

The sensation of breathlessness does not necessarily mean that oxygen therapy is called for, and before recommending oxygen therapy doctors will usually want to test levels of oxygen in the blood.

Oxygen therapy is not normally available to people who smoke, because of the potential fire risk of oxygen tanks around a naked flame.

Physical rehabilitation

Doctors sometimes ask patients to go on graded exercise programmes as part of what they call pulmonary rehabilitation. Graded exercise programmes aim to improve your general fitness, and can have a marked effect on your quality of life, regardless of your initial level of fitness. Pulmonary rehabilitation seeks to gradually improve your fitness, and exercises designed to increase your muscle strength. Some courses also include advice on nutrition. Pulmonary rehabilitation programmes are usually run in hospitals. If you feel you would benefit from this type of programme, ask your doctor.