Understanding COPD treatments

If you have COPD, like diabetes and heart disease, the condition will not go away. But there are things that will allow you to do more than you used to. This includes treatments, immunisations, stopping smoking and taking more exercise. The lungs may have some permanent damage, but you can do a lot to let yourself do more (and the treatments can help).

Stop smoking

If you smoke, stopping is a really effective way to prevent COPD from getting worse. While lung damage cannot be reversed, quitting smoking can prevent further harm. It will help you get the most out of your lungs.

Your healthcare professional and pharmacist can help you find ways to make it easier for you to stop. You’re around three times more likely to quit with help from support services and medication.

It is really useful to get help at any stage of your COPD. Healthcare professionals will point you in the right place to get help stopping smoking. We often relapse, so don’t feel guilty asking again if things don’t work out.

Inhalers

Everyone with COPD should aim to be as fit as they can. This can minimise your symptoms, reduce infections and allow you to do much more. But you will still be helped with some of the inhalers that are available.

An inhaler is a device that delivers medicine directly into your lungs. It is very important to get the technique right as this will allow you to get the best benefit from the medicine.

There are several different types of inhalers for COPD. Some of them have long names that are a bit of a mouthful, but here’s a short overview:

Short-acting bronchodilator inhalers

For most people with COPD, these inhalers are the first treatment used. Bronchodilators are medicines that make breathing easier. They do this by relaxing and widening your airways a little.

Short-acting inhalers should be used when you feel breathless, up to 4 times a day.

Long-acting bronchodilator inhalers

A long-acting bronchodilator inhaler may be recommended if:

• you experience symptoms regularly
• have flare-ups (exacerbations) despite using short-acting bronchodilators.

These work in a similar way to short-acting bronchodilators, but each dose lasts for at least 12 hours. They only need to be used once or twice a day.

Steroid inhalers

Your healthcare professional may suggest including a steroid inhaler if:

• You're still becoming breathless when using a long-acting inhaler
• You have frequent flare-ups

Steroid inhalers contain corticosteroid medicines. This can help to reduce the inflammation in your airways. These have a very low dose designed to help your airways. They also have minimal risk compared to higher dose steroids by mouth or injection.

Steroid inhalers are normally prescribed as part of a combination inhaler. These include a long-acting medicine.

Tablets

A doctor may also recommend taking tablets or capsules if symptoms aren't controlled. There are a few different kinds. They are not used too often as some can have significant side effects:

• Antibiotics. Your doctor may prescribe a short course of antibiotics if you have signs of a chest infection. The course is usually 5 days, which is the safest duration for most people.
• Mucolytics. Your doctor may recommend taking a mucolytic if you have a persistent chesty cough with lots of thick phlegm. These tablets make the phlegm in your throat thinner and easier to cough up. They are not required to be used regularly by many people but may help.
• Steroid tablets. If you have a particularly bad flare-up, you may be prescribed a short course of steroid tablets. These reduce the inflammation in your airways. A 5-day course of treatment is usually recommended to avoid any side effects.
• Theophylline tablets. A type of bronchodilator that seems to reduce inflammation in the airways. They also relax the muscles lining them. You may need regular blood tests during treatment to check the level of medicine in your blood. These drugs need careful monitoring.

Pulmonary rehabilitation

Pulmonary rehabilitation is a specialised exercise and education programme. It supports people with lung conditions like COPD.

It can help improve how much exercise you can do before you feel out of breath. It can also improve your symptoms, self-confidence and emotional wellbeing.

Pulmonary rehabilitation programmes usually involve two or more weekly group sessions for at least 6 weeks.

A typical programme includes:

• physical exercise training tailored to your needs and ability. This could be walking, cycling and strength exercises
• education about your condition for you and your family
• dietary advice
• psychological and emotional support

Other treatments

If you have severe symptoms or experience a particularly bad flare-up, you may need extra treatment.

These treatments can include:

• Nebulised medicine. This turns the medicine into a fine mist you breathe in through a mouthpiece or face mask. These can have significant side effects and need to be monitored carefully. These include infection risks, problems with heart rhythms and problems with muscle weakness.
• Long-term oxygen therapy. If COPD causes a low level of oxygen in your blood, you may be advised to have oxygen at home through nasal tubes or a mask. This can help stop the oxygen level in your blood from becoming dangerously low. But, this is not a treatment for the main symptoms of COPD, such as breathlessness. Oxygen is considered too dangerous if you are still smoking. So if this is recommended, it is worth getting professional help and the medications to stop smoking.