Other medications in chronic obstructive pulmonary disease (COPD)

Although anticholinergics, beta2-agonists, and corticosteroids are the medications most often used in chronic obstructive pulmonary disease (COPD), other medications are occasionally prescribed.

Leukotrienes

Leukotrienes play an important role in causing airway inflammation, especially in asthma. In COPD, leukotrienes have been shown to be elevated in the airways and may be important for recruitment of inflammatory cells into the lung. Leukotriene drugs work by either inhibiting leukotriene production or by blocking the action of certain leukotrienes at their receptors.

These drugs have been shown to improve symptoms in asthmatics but have not been shown to be effective in COPD, and at the present time these drugs are not recommended for people with COPD.

Cromolyn and nedocromil

Cromolyn and nedocromil have similar anti-inflammatory actions. They work on specialized white blood cells called mast cells. Mast cells line the airways and can be stimulated to release substances that cause inflammation and muscle contraction around the airways. It is mast cells that can cause sudden (acute) breathing problems when a person is exposed to a substance to which they are allergic.

Cromolyn and nedocromil block channels in mast cells to prevent the cells from releasing the substances that trigger inflammation. They are effective at reducing symptoms of cough and shortness of breath. They may help to reduce symptoms that are triggered by cold air or exercise.

In COPD, these medications are not very effective and rarely are used.