Managing chronic obstructive pulmonary disease (COPD) and asthma can mean the difference between staying active and being stuck at home. Taking medication every day — called maintenance therapy — helps keep your airways open and prevent your symptoms from flaring up.
Work closely with your doctor to find a maintenance therapy that controls your symptoms and has the fewest side effects. Here are some topics and questions to get you started.
Talk about your symptoms
Knowing your symptoms and how they’ve changed will help your doctor choose the maintenance therapy that’s most likely to control them. Typical COPD/asthma symptoms include:
- shortness of breath
- a cough that doesn’t go away
- chest tightness
- excess mucus
- blue lips
- lung infections
Before your visit, keep a log of your symptoms. Also, write down the answers to these questions:
- Which symptoms do you have? Shortness of breath? Wheezing? Coughing? Other symptoms?
- What seems to trigger your symptoms? What makes them better?
- How severe are your symptoms?
- Which of your daily activities do they affect — dressing, walking, shopping, etc.?
- Have your symptoms gotten worse over time?
- Do you have to use your rescue inhaler more often than you used to?
- Do you wake up in the middle of the night and need your inhaler?
This log will help you have a more informed discussion with your doctor about your COPD.
Choosing a maintenance medication
Maintenance or control medications prevent COPD symptoms long-term. You must take these drugs every day for them to work.
Several different medications treat COPD. Treatment for COPD differs from person to person. Finding the best medication to control your symptoms can take some trial and error.
Drugs called bronchodilators are staples of COPD maintenance therapy. You breathe them in through an inhaler. They work by relaxing the muscles around your airways so it’s easier for you to exhale.
Your options include:
- Long-acting beta-agonists: arformoterol (Brovana), formoterol (Foradil, Performist), indacaterol (Arcapta), salmeterol (Serevent)
- Long-acting anticholinergics: aclidinium (Tudorza), glycopyrrolate (Seebri), tiotropium (Spiriva)
- Combinations of long-acting bronchodilator drugs: glycopyrrolate-indacaterol (Utibron), tiotropium-olodaterol (Stiolto), umeclidinium-vilanterol (Anoro)
Speak with your doctor about which types of maintenance medications are good options for you.
Talk about side effects
When choosing a COPD maintenance medication, consider not only whether the drug will control your symptoms, but also what side effects it might cause.
COPD medicines can cause side effects such as:
- shakiness or jittery feeling
- fast heartbeat
- nausea and vomiting
Let your doctor know if you have any side effects from your treatment. If you can’t tolerate the side effects of the drug you’re on, you might need to switch to something else.
Create a COPD plan
Once you and your doctor have selected a COPD treatment, put these two plans in place:
- COPD management plan. This is an overview of your therapy. It includes your current medicines, oxygen settings, and other health conditions.
- COPD action plan. This is an outline of the steps to take if your symptoms get worse.
Bring these two plans with you to every doctor visit. Update them as your symptoms and treatments change.
Consider lifestyle changes
Bronchodilators aren’t the only treatment for COPD. Making a few changes to your daily routine can also help you gain more control over your symptoms.
- Don’t smoke. This is the most important thing you can do to prevent symptoms — and it’s also the hardest to accomplish. Quitting isn’t easy, but you can do it. Ask your doctor to recommend ways to reduce your urge to smoke, such as nicotine replacement products or medications. Avoid being around other people smoking, too. Secondhand smoke also irritates the lungs.
- Get vaccinated. A yearly flu shot, along with the pneumococcal vaccine, can prevent lung infections that worsen COPD symptoms.
- Try pulmonary rehabilitation. This program teaches you strategies like better nutrition and exercise to help you get around more easily.
- Use oxygen. If you struggle to catch your breath even when taking medications for COPD, inhaling supplemental oxygen may help. Have your oxygen levels checked by your doctor.
Questions to ask your doctor
If you need some direction when talking to your doctor about your COPD, here are a few questions to help guide the discussion:
- How should my medication affect my symptoms?
- What side effects can the medication cause? What should I do if I have side effects?
- Am I using my inhaler correctly?
- What should I do if I miss a dose or two?
- Which vaccinations do I need?
- Could pulmonary rehabilitation help me?
- Should I be on a special diet?
- Is it safe for me to exercise? What kinds of exercises are best for me?
- Do I need supplemental oxygen?
- What should I do if my symptoms get worse?
- When should I call you?
Keep the lines of conversation with your doctor open. Call if your symptoms get worse or you have trouble keeping up with your COPD plan.