Emphysema: Diagnosis and Treatments
Treating emphysema focuses on improving emphysema symptoms -- mainly shortness of breath. Some emphysema treatments can reduce the number of hospitalizations and help preserve lung function.
Inhaled bronchodilators relax and open the airways. They may be short-acting (albuterol, ipratropium) or long-acting (formoterol, salmeterol, tiotropium, olodaterol, umeclidinium, vilanterol, and aclidinum bromide). These medicines may be available as inhalers ("puffers") or as a solution. A nebulizer machine aerosolizes the bronchodilator solution, which is then breathed through a tube. Some drugs have a combination of bronchodilators.
Inhaled corticosteroids reduce inflammation in the airways. Although inflammation is not generally felt to be a large contributor to emphysema, these medicines often still help. Numerous corticosteroids are available, such as fluticasone or beclomethasone. Corticosteroids are also available with bronchodilators in combined preparations, like Advair and Breo Ellipta.
Oral or intravenous corticosteroids are used for exacerbations (sudden worsening) of emphysema. These medicines (prednisone, methylprednisolone) are effective, but can have serious side effects if used regularly.
Another oral drug, Daliresp, is an inhibitor of an enzyme called phosphodiesterase type 4 (PDE-4). The drug prevents COPD flares in people whose condition is associated with chronic bronchitis. Daliresp is not intended for other types of COPD.
Besides medications, other treatments include:
Oxygen therapy: People with severe emphysema and low oxygen in the blood can benefit from long-term oxygen therapy. Oxygen therapy reduces strain on the heart and helps some people with severe emphysema live longer. Oxygen therapy is typically inhaled through the nose by a tube called a nasal cannula. Some may need oxygen therapy continuously, others may not.
Lung volume reduction surgery: Surgical removal of large areas of damaged lung can improve function of the healthy part of the lung. This can improve breathing and quality of life.
Pulmonary rehabilitation: An intensive program that combines exercise, nutrition, counseling, and medication management; people with severe emphysema often breathe better through this diverse and aggressive treatment approach.
Lung transplantation: This is the most drastic of emphysema treatments. Although it could be called an emphysema cure, lung transplant can create medical problems that can be worse than severe emphysema.