Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term for a group of progressive lung conditions including:
- Chronic bronchitis
- Chronic asthma
The conditions have in common that they cause narrowing of the airways, or bronchi, in the lungs, which makes it difficult to breathe. While COPD is currently incurable, it can be managed effectively with the right treatment.
Thankfully, there are a variety of options available to treat COPD. So, if you are affected by this condition, there will be an effective plan that will work for you. To give you an idea as to what’s available, we have created this guide to COPD treatments.
What treatments exist for COPD?
The main goal of COPD treatments is to relieve the many debilitating symptoms of COPD; including coughing, wheezing, shortness of breath, etc. The many treatments listed below serve that purpose through differing methods; including physical rehabilitation, different kinds of medications and other avenues for managing COPD.
Like with anything else, different treatments are going to work for different people. The respiratory specialist you consult will work with you to ensure that you receive the care that is going to provide you with the best relief and quality of life.
This is considered one of the most effective treatments for COPD, and is therefore recommended for all COPD patients that are short of breath on exertion, including in the period following an acute exacerbation.
It is a multi-faceted approach to reducing breathlessness and improving quality of life, and is delivered by an interdisciplinary team of therapists. Pulmonary rehabilitation consists of various components that include:
- Exercise training – promoting regular physical activity for overall quality of life
- Education – strengthening the patient’s understanding as to COPD and determining the treatment options that will work best for them
- Nutrition counselling – tailoring the patient’s diet so that their nutritional status does not negatively affect their breathing
- Psychosocial support – addressing symptoms of anxiety and depression that may arise as the result of COPD, as these mental conditions can significantly hamper treatment effectiveness
There is a wide range of medications available to treat COPD and manage symptoms. The two kinds of COPD medications are bronchodilators, which relieve breathlessness, and inhaled corticosteroids, which help reduce flare ups, or exacerbations, in people for whom that is an issue. The majority of these medications are delivered through inhalers so that they can be delivered directly into the lungs.
These medications for COPD include:
Short acting bronchodilators
These medications are used for the quick relief of COPD symptoms, typically lasting about 4-6 hours.
- short-acting beta-2 agonists (SABAs) such as salbutamol (Ventolin, Asmol or Airomir) and terbutaline (Bricanyl Turbuhaler)
- short-acting muscarinic antagonists (SAMAs) such as ipratropium (Atrovent)
Long acting bronchodilators
These medications are used for long term management of COPD symptoms as well as the prevention of flare ups. They typically last about 12-24 hours.
- long-acting beta-2 agonists (LABAs) such as indacaterol (Onbrez Breezhaler), salmeterol (Serevent Accuhaler) and formoterol (Oxis, Foradile)
- long-acting muscarinic antagonists (LAMAs) such as tiotropium (Spiriva), glycopyrronium (Seebri), umeclidinium (Incruse Ellipta ) and aclidinium (Bretaris Genuair)
Combination bronchodilators plus inhaled corticosteroids
These are typically prescribed to treat COPD if:
- you have regular flare-ups of your COPD
- you still have symptoms after using a long-acting inhaler
- your condition is an overlap of COPD and asthma
Bronchodilators in tablet form
In some cases of severe COPD, methylxanthines such as theophylline may be prescribed. These medicines are less commonly used because they can interact with other medicines (such as some antibiotics) and can have serious side effects.
These kinds of tablets are designed to reduce inflammation in the lungs that leads to the swelling and narrowing of the airways and are commonly used for short periods of time during flare-ups of COPD.
Antibiotics and Mucolytics
If your COPD flare ups are caused by bacteria, your doctor will prescribe antibiotics. If your symptoms include a build up of sticky mucus, you may also be prescribed a mucolytic in a tablet or liquid form.
Long term oxygen therapy (LTOT) is the provision of supplemental oxygen therapy for 15 hours per day or more. This treatment, although not as common as the others on this list, is prescribed for people with persistently low levels of oxygen in the blood.
In Australia, LTOT is mostly delivered in the home using an oxygen concentrator, a device that removes nitrogen from room air, thereby increasing the concentration of oxygen. Sometimes oxygen cylinders are provided for short-term or portable use.
Non-invasive ventilation (NIV) refers to the administration of ventilatory support using a face mask or nasal mask, rather than an invasive artificial airway (such as a tube). Air, usually with added oxygen, is given to the patient through the mask under positive pressure, where the amount is altered depending on whether the patient is breathing in or out.
Vaccination reduces the risks associated with influenza and pneumococcal infection and these are leading causes of exacerbations and healthcare visits. As a result, influenza immunisation and pneumococcal immunisation is recommended for all patients with COPD, in addition to COVID vaccination.
In the event that the COPD patient is a smoker, the most beneficial immediate step in any recovery plan for COPD patients is to stop. Stopping smoking is the only intervention that has been shown to improve the natural progression of COPD. For example, it helps to improve a patient’s cough, ease breathlessness and slow down further lung damage.
COPD Frequently Asked Questions
What are its symptoms?
The symptoms of COPD include:
- breathlessness after exertion
- in severe cases, breathlessness on minimal exertion or even at rest
- coughing up sputum (mucus or phlegm)
- cyanosis – a blue tinge to the skin caused by insufficient oxygen
- increased susceptibility to chest infections.
What are lungs and how do they work?
The lungs are an air filled organ inside the chest that are protected by the ribcage. Inhaled air is directed down the trachea (windpipe) into two tubes (bronchi) that each connect to a lung. The bronchi divide into smaller tubes called bronchioles, and further still into tiny air sacs called alveoli.
Each alveolus has a fine mesh of capillaries where the exchange of oxygen and carbon dioxide takes place. Oxygen molecules dissolve and migrate across a thin film of moisture from the air sac to the bloodstream. Oxygenated blood is sent to the heart and then pumped around the body.
At the same time, carbon dioxide in the blood crosses from the capillaries to the air sacs using the same film of moisture. The carbon dioxide is then exhaled.
How does COPD affect the function of the lungs?
Typically, COPD develops so slowly that you don’t realise your ability to breathe is gradually becoming impaired. The damage done to the lungs can be considerable before the symptoms are severe enough to notice until other conditions arise, such as emphysema and bronchitis.
People with emphysema have damaged alveoli and bronchi. The weakened and ruptured air sacs are unable to efficiently move oxygen from the air to the blood. As the disease progresses and damages more air sacs, you may eventually feel breathless even when you are resting.
Bronchitis means inflammation of the bronchi. The lungs normally produce a small amount of fluid to keep healthy, but chronic bronchitis causes an overproduction of fluid. This leads to frequent and productive coughing (producing mucus or phlegm).
What health complications can COPD lead to?
If COPD is not addressed and treated, it can lead to the following health complications:
- chest infections – a common cold can easily lead to a severe infection
- pneumonia – a lung infection that targets the alveoli and bronchioles
- collapsed lung – the lung may develop an air pocket. If the air pocket bursts during a coughing fit, the lung will deflate
- heart problems – the heart has to work extremely hard to pump blood through the damaged lungs
- osteoporosis – where bones become thin and break more easily. Steroid use in people with COPD is thought to contribute to osteoporosis
- anxiety and depression – breathlessness or the fear of breathlessness can often lead to feelings of anxiety and depression
- oedema (fluid retention) – problems with blood circulation can cause fluid to pool, particularly in the feet and ankles
- hypoxaemia – caused by lack of oxygen to the brain. Symptoms include cognitive difficulties such as confusion, memory lapses and depression
- risks of sedentary lifestyle – as symptoms of COPD progress, many people adjust their lifestyle to avoid symptoms, which means forgoing healthy activity which leads to other potentially serious health problems, such as obesity and cardiovascular disease
What are the causes of COPD?
Some of the causes and risk factors of COPD include:
- cigarette smoking
- long-term exposure to lung irritants
- genetic predisposition
How do you diagnose COPD?
The diagnosis of COPD is based on a breathing test called spirometry. This can be done in a general practice surgery, specialised laboratory or by a specialist.
Other tests that may also be carried out include:
- physical examination
- medical history
- gas transfer and lung volume tests
- blood tests
- sputum analysis
- chest x-ray
- computed tomography (CT) scan
Where can I go for high quality COPD treatments?
At Manse Medical, we provide both high quality diagnosis and treatment for respiratory disorders such as COPD. Book your appointment online by selecting your preferred clinic and choose from the list of our available specialists.