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Chronic obstructive pulmonary disease - Treatment

Alternative Names

COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic

Treatment:

There is no cure for COPD. However, there are many things you can do to relieve symptoms and keep the disease from getting worse.

Persons with COPD MUST stop smoking. This is the best way to slow down the lung damage.

Medications used to treat COPD include:

  • Inhalers (bronchodilators) to open the airways, such as ipratropium (Atrovent), tiotropium (Spiriva), salmeterol (Serevent), formoterol (Foradil), or albuterol
  • Inhaled steroids to reduce lung inflammation
  • Anti-inflammatory medications such as montelukast (Singulair) and roflimulast are sometimes used

Click here to see a video about COPD inhalers.

In severe cases or during flare-ups, you may need to receive:

  • Steroids by mouth or through a vein (intravenously)
  • Bronchodilators through a nebulizer
  • Oxygen therapy
  • Assistance during breathing from a machine (through a mask, BiPAP, or endotracheal tube)

Antibiotics are prescribed during symptom flare-ups, because infections can make COPD worse.

You may need oxygen therapy at home if you have a low level of oxygen in your blood.

Pulmonary rehabilitation does not cure the lung disease, but it can teach you to breathe in a different way so you can stay active. Exercise can help maintain muscle strength in the legs.

Walk to build up strength.

  • Ask the doctor or therapist how far to walk.
  • Slowly increase how far you walk.
  • Try not to talk when you walk if you get short of breath.
  • Use pursed lip breathing when breathing out (to empty your lungs before the next breath)

Things you can do to make it easier for yourself around the home include:

  • Avoiding very cold air
  • Making sure no one smokes in your home
  • Reducing air pollution by getting rid of fireplace smoke and other irritants

Eat a healthy diet with fish, poultry, or lean meat, as well as fruits and vegetables. If it is hard to keep your weight up, talk to a doctor or dietitian about eating foods with more calories.

Surgery may be used, but only a few patients benefit from these surgical treatments:

  • Surgery to remove parts of the diseased lung can help other areas (not as diseased) work better in some patients with emphysema
  • Lung transplant for severe cases

Support Groups:

People often can help ease the stress of illness by joining a support group in which members share common experiences and problems.

See also: Lung disease - support group

Expectations (prognosis):

COPD is a long-term (chronic) illness. The disease will get worse more quickly if you do not stop smoking.

Patients with severe COPD will be short of breath with most activities and will be admitted to the hospital more often. These patients should talk with their doctor about breathing machines and end-of-life care.

Complications:

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if you have a rapid increase in shortness of breath.

  • Reviewed last on: 5/1/2011
  • Denis Hadjiliadis MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Hoogendoorn M, Feenstra TL, Hoogenveen RT, Rutten-van Mölken MP. Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD. Thorax. 2010;65(8):711-718.

Agarwal R, Aggarwal AN, Gupta D, Jindal SK. Inhaled corticosteroids vs placebo for preventing COPD exacerbations: a systematic review and metaregression of randomized controlled trials. Chest. 2010; 137(2):318-325.

Shapiro SD, Reilly JJ Jr., Rennard SI. Chronic bronchitis and emphysema. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 39.

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