Medications May Help Reduce Chronic Obstructive Pulmonary Disease Symptoms
Despite their fixed lung obstruction, many people with COPD also have some reversible airway obstruction that may respond somewhat to bronchodilators. A short-acting bronchodilator may be prescribed for occasional symptoms, while more frequent symptoms may call for a long-acting bronchodilator. The beta2 agonists and anticholinergics are used most often. The methylxanthine derivative theophylline is less effective than beta2 agonists, but it eases symptoms in about 20 percent of people with COPD.
If bronchodilators fail to relieve airway obstruction adequately, corticosteroids (both oral and inhaled) may diminish inflammation in some people. However, corticosteroids are less effective for COPD than for asthma, and their side effects may be more severe in older people.
Because of the difficulty in predicting who will respond to corticosteroid therapy, it is common to institute a two- to three-week trial period of oral corticosteroids, used under careful monitoring and discontinued immediately if they show no benefit. For people who do show improvement, the medications are tapered to the lowest effective dose.
The long-acting beta2 agonist Advair (salmeterol and fluticasone) has demonstrated mixed results for the treatment of COPD. Another long-acting beta2 agonist, Symbicort, is also now available. Symbicort contains budesonide and formoterol and has been approved for the maintenance treatment of COPD.
Currently, both Advair and Symbicort are recommended only for individuals with severe COPD who experience frequent flare-ups.
Expectorants (such as guaifenesin, found in Mucinex, Robitussin and other medications) may help loosen mucus secretions in the airways. Antibiotics (such as azithromycin, tetracycline, ampicillin, erythromycin, and combinations of trimethoprim and sulfamethoxazole) are prescribed when increased production of yellow or green phlegm signals a respiratory infection, which can aggravate COPD.
Although moderate worsening of symptoms can be treated at home, severe episodes require hospitalization.
Mucus Clearance Devices to Treat COPD
People with COPD who have chronic, moderate to severe mucus accumulation may benefit from a mucus clearance device—a small, handheld object shaped like a pipe. Blowing into it creates vibrations in the chest that loosen mucus and help medication penetrate the lungs more easily. Some studies suggest that using a mucus clearance device before an inhaled bronchodilator can improve both lung function and exercise capacity, while reducing shortness of breath.
Vaccinations in People with COPD
People with COPD should have annual flu shots as well as a pneumonia vaccination every five to 10 years. These steps minimize the risk of infections that can lead to episodes of temporary but severely worsened symptoms.
