When you have
COPD, especially if you have chronic
bronchitis, you may sometimes have sudden attacks
where your breathing and coughing symptoms suddenly get worse and stay that
way. These attacks are called COPD exacerbations, or flare-ups.
With treatment, many people recover and return to the same level of shortness
of breath they had before the attack.
The GOLD classifications are the main method doctors use to describe the severity of chronic obstructive pulmonary disease (COPD).
GOLD is short for the Global Initiative for Chronic Obstructive Lung Disease, a collaboration between the National Institutes of Health and the World Health Organization.
A lung infection, such as
acute bronchitis or
pneumonia. Infections are the most common cause of
COPD attacks. Infections usually are caused by viruses but can also be caused
Other causes may include
allergic reactions, inhaling food or stomach contents
into the lungs, and exposure to temperature changes or chemicals. In about 33
out of 100 attacks-about a third-the cause is not known.1
Here's what happens during an attack:
Your lungs may suddenly produce more
mucus. Or the airways of your lungs (bronchial tubes)
may suddenly get narrower.
These two things reduce the airflow in
And that makes it harder to breathe and makes your
In a COPD
attack, your usual symptoms suddenly get worse:
Oral corticosteroids, which
are medicines that reduce the swelling in your airways and may make breathing
easier. They are typically given for 5 days to up to 14 days to those who
aren't already taking them as part of their long-term treatment.
A machine to help you breathe. This is
called mechanical ventilation. It is used only if medicine is not helping and
you are having a very hard time breathing.
Oxygen, to increase the amount of oxygen in your
Antibiotics, which are often used
when a bacterial infection is considered likely. People with COPD have an
increased risk of
pneumonia and frequent lung infections. Although most
infections are caused by viruses, some are caused by bacteria. Most studies
support the use of antibiotics. But some experts believe that since most
breathing attacks are caused by viruses, antibiotics should not be used unless
there is a known bacterial infection.
Diuretics, which remove water from the body by making
your body produce more urine. These medicines are used if you are suspected of
having heart failure.
Global Initiative for Chronic Obstructive Lung Disease
(2009). In Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Available online:
Primary Medical Reviewer
Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer
Ken Y. Yoneda, MD - Pulmonology
May 4, 2010
WebMD Medical Reference from Healthwise
May 04, 2010
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