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What Are the First-Line Treatments for COPD?

Overview of COPD

Most people don’t have to think about breathing — until it becomes difficult. For the more than 11 million Americans who have chronic obstructive pulmonary disease (COPD), breathing becomes a priority. COPD is a condition in which the process of getting air in and out of your lungs becomes increasingly difficult. As the disease worsens, it can reduce your ability to be active and enjoy a normal lifestyle.

COPD can be life-threatening. According to the Centers for Disease Control and Prevention, COPD is the third leading cause of death in the United States, behind heart disease and cancer. COPD can’t be reversed, but if you have the disease, it can be treated to slow its progression and increase your comfort.

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Treatments

Treatments for COPD

If you’ve been diagnosed with COPD, your doctor will work with you to determine the best treatment options. The most important consideration will be the severity of your disease.

COPD often shows no symptoms until it has progressed to later stages. There’s no cure for COPD, but beginning treatment as early as possible can help ease its symptoms and possibly slow it down.

Smoking cessation

If you’re still smoking when diagnosed with COPD, it’s more important than ever to stop. Quitting will help you breathe more easily and reduce your cough. Speak with your doctors about the many options to support your effort to quit.

Bronchodilators

Bronchodilators help your bronchial muscles relax and open wider. This clears your airways, making it easier for you to breath. Bronchodilators are normally either short-acting or long-acting.

Many different medications are bronchodilators, and most fall into these categories:

Category How it works Method of delivery, Form Common side effects
Beta2-agonist Relaxes muscles around the small airways Oral, inhalation Rapid heart rate, and sometimes restlessness and tremor
Anticholinergic Relaxes muscles around the large airways Oral, inhalation Dry mouth
Steroid or glucocorticosteroid  Anti-inflammatory medications that reduce swelling of the airways Oral, capsule/inhalation • Capsule: difficulty sleeping, increased appetite, fluid retention, restlessness
• Inhalation: irritation of mouth and throat, fungal infections of mouth and throat, hoarseness
Theophylline  Relaxes the muscles in your airways and is thought to decrease swelling in the lungs Oral, inhalation Upset stomach. Can also cause serious side effects, including irregular heartbeat and seizures.
Mucolytic Breaks up mucus and helps clear your airways Oral, capsule/tablet/syrup Stomatitis, nausea, vomiting, fever, drowsiness, chest tightness

Combinations of bronchodilator medications are also frequently prescribed. For instance, according to a study in the journal COPD, the combination of beta2-agonists and a corticosteroid can be more effective than either drug alone.

Antibiotics

Antibiotics are important in treating COPD, because symptoms are often triggered or made worse by bacterial infections such as sinusitis or pneumonia. Also, when you have a viral infection or flu, secondary bacterial infections may follow.

Supplemental oxygen

If your COPD is severe and your blood oxygen levels are low, your doctor may prescribe supplemental oxygen. You may require oxygen only when you’re getting exercise or sleeping. However, most people use oxygen throughout the day and night, breaking for activities such as bathing. You will continue to take your prescribed medications even if you’re on oxygen therapy.

Physicians at Texas A&M University Health Science Center report oxygen prolongs life by reducing the strain low oxygen places on your heart. It also decreases shortness of breath and enables you to sleep better and be more active.

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Causes

Causes of COPD

Approximately 85-90 percent of COPD is caused by smoking cigarettes. This means COPD can be prevented for most people. Other causes of COPD include:

  • air pollution
  • environmental pollution, such as secondhand smoke and industrial pollution
  • a genetic disorder called alpha-1 antitrypsin deficiency (AAT), which occurs in a small number of people
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Outlook

Outlook

If you have COPD, your doctor may try various treatments to find what works best for you. Symptoms of COPD typically get worse as the disease progresses. However, with effective treatment, many people are able to breathe easier, enjoy a more active life, and slow the progression of the disease.

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