Some people may require medicine to help them manage their COPD symptoms. It is important that you understand how your medicines work and then take them as prescribed.
COPD medication works by either opening up the airways (beta agonists) or by relaxing the muscles around the airways (muscarinic antagonists). Both of these medications work to relieve COPD symptoms and make breathing easier.
There are 3 different types of COPD medicines, which are used in different settings:
After being diagnosed with COPD, most people are prescribed a reliever (short-acting bronchodilator) inhaler. A reliever inhaler relaxes and widens your airways to help you breathe easier. These medicines begin working quickly, and you should find it easier to breathe within minutes.
Your reliever inhaler (puffer) should only be used when you notice you are wheezing, coughing, out of breath or feel a tightness in your chest. Relievers can also be used before exercising or performing a strenuous task.
If you need to use your reliever inhaler more than four times per day, you need to consult your healthcare practitioner. You may need to change to a long-acting bronchodilator.
Maintenance inhalers (long-acting bronchodilators) are used if symptoms remain, despite using a reliever. Most maintenance medicines take longer than relievers to begin working. Each dose of a maintenance inhealer lasts for at least 12 hours, compared to four hours for reliever inhalers.
The two types of maintenance inhalers are:
· Long-acting muscarinic antagonists (LAMA)
· Long-acting beta agonists (LABA)
LAMA inhalers are recommended first-line as a maintenance inhaler for COPD. However, if a LAMA inhaler by itself is not enough to control breathlessness or flare-ups, a combination inhaler with both a LAMA and LABA can be used.
Some people with severe COPD benefit from having an inhaled corticosteroid (ICS) along with a maintenance inhaler. ICS can help if people are having frequent flare-ups. ICS can help reduce inflammation in the lungs and will often be given as a combination inhaler along with a maintenance medicine (i.e. ICS/LABA).
Your healthcare practitioner may look at blood test results to help them work out if an ICS is likely to be helpful. They may also give you a trial of treatment for a few months to see if it helps you. If this medication proves to be useful, it must be taken every day to have effect.
Chest infections can be a problem when you have COPD. Antibiotic treatment may be necessary if you have increased mucus, your mucus changes colour and you generally feel unwell. If you are prescribed antibiotics, you must always take the complete course, even if your symptoms improve. This is to prevent relapse and to avoid the development of antibiotic resistance.
A small number of people who are having a lot of flare-ups will benefit from long-term antibiotics. These can have side-effects, so would usually only be prescribed by a specialist hospital service.
Oxygen therapy is not used to treat breathlessness. Instead, it is used when the damage to your airways causes a low concentration of oxygen in your blood. Oxygen therapy can increase your energy and ability to exercise, as well as reduce the risk of damage to your heart. If you are prescribed long-term oxygen therapy, it will be recommended that you use oxygen for at least 16 hours per day. Oxygen therapy can only be prescribed to non-smokers, as having oxygen in the house is a fire risk.