Which Devices Help Treat COPD?

Although there's no cure for chronic obstructive pulmonary disease (COPD), inhaled medication can help. Portable oxygen therapy is another device-based treatment for people with the lung disease who need extra oxygen.

Inhalers and Nebulizers

There are two main ways inhaled medicine is used: with an inhaler and with a nebulizer.

Inhalers and nebulizers have the same purpose: to get the medicine into your lungs. Both deliver the same type of medicine, and they work equally well when you use them the way you should.

Inhalers and nebulizers are available only by prescription. You might see some bronchodilator inhalers sold over the counter, but don't use them unless your doctor recommends it. They could be dangerous for people with certain health conditions, such as heart problems.

Inhalers

These small, handheld devices deliver a puff of medicine into your airways. There are three basic types:

  • Hydrofluoroalkane inhalers (HFA, formerly metered dose inhaler or MDI)
  • Dry powder inhalers (DPI)
  • Soft mist inhalers (SMI)

HFAs contain a liquid medication that you get through an aerosol spray. The medicine is in a pressurized canister that has a metering valve. You close your lips around the mouthpiece or place the mouthpiece 1 to 2 inches from your mouth and breathe in slowly as you press down on the inhaler.

Many people like to use a spacer. It’s a hollow plastic tube that is attached between the mouthpiece and the canister of medicine. A spacer makes it easier to get the full dose of medication all the way to your lungs.

A DPI is similar to an HFA, but it releases a puff of dry powder instead of a liquid mist. You shouldn’t use a DPI with a spacer. Instead, close your mouth tightly around the mouthpiece of the DPI inhaler and inhale rapidly and steadily. It’s important to remove the device from your mouth before you exhale so that humid air doesn’t get into the device and make the powder clump.

An SMI is a newer type of inhaler that provides a measured amount of medicine in a slow-moving mist that helps you inhale the medicine. You put your lips on the mouthpiece while you hold the device horizontally. Be careful not to cover the air vents. This type of device actively delivers medicine in a way that doesn’t depend on how fast you breathe in the air from the inhaler.

Though inhalers use the same general principle, they don’t all work the same way. For instance, you should shake an HFA before using it, but you never shake a DPI.

Each device is cleaned differently and has a different way of tracking when it’s empty. Always follow the instructions for your specific device.

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Nebulizers

These machines change a liquid medicine into a mist that you inhale into your lungs. Nebulizers aren't very portable, so you keep a nebulizer at home.

To use it, you measure out the medicine into a cup and attach the cup with tubing to the machine. Then you turn it on, relax, and breathe the mist in deeply through a mouthpiece or mask.

Depending on the medication, it usually takes 20 minutes or less to inhale the medicine. Afterward, you need to clean the nebulizer and mouthpiece or mask with water (and soap every now and then) before you use it again.

Inhaler vs. Nebulizer

Which approach is better: a nebulizer or an inhaler? It depends on what your doctor recommends, your own preference, and what your insurance will cover. The key is to make sure you feel comfortable with whichever one you choose and use it the right way.

Most people with COPD use an inhaler. One big advantage is that they're portable. While you have to use a nebulizer at home (or in a medical facility), you can carry an inhaler in your pocket. Inhalers also deliver medication more quickly. After a few puffs, perhaps taken a minute or 2 apart, you're done.

It can take some practice to use an inhaler correctly. Many studies have found that fewer than half the people with HFAs for asthma or COPD actually use them the way they should.

If you have trouble with inhalers, nebulizers can be the best choice for you. They also can help temporarily if you have a COPD flare-up. Some people just prefer nebulizers and feel that they're more effective.

Because nebulizers are expensive and need maintenance, insurance companies might be less likely to cover them for long-term use. Check your plan.

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5 Tips for Using Inhaled COPD Medicine

  1. Know how to use it. If you don’t use inhaled medicine correctly, it won't help you. When you get the prescription, go over the instructions with your doctor or pharmacist -- or, if you have a nebulizer, with a representative from the medical supply company. After that, check in sometimes to make sure that you're still using it properly.
  2. Know when to use it. If your doctor prescribes a nebulizer or inhaler, make sure you understand when to use it. Is it only for times when you have a COPD flare-up? Or do you need it every day?
  3. Know how much you need. Always follow the prescription exactly. Never take more or less than your doctor recommends. If you have a COPD flare-up and your normal dosage doesn’t help, don't keep taking more. Instead, get medical help right away.
  4. Know what the drug does. You might need more than one kind of inhaled medication. The most common treatment for COPD is a bronchodilator, which relaxes the muscles around the airways, allowing them to open up. There are many types of bronchodilators. Some people with COPD need treatment with inhaled corticosteroids, which can curb swelling in the air passages. Some of these medications are short-acting. Others are long-acting. And some kick in quickly, while others take time to work.
  5. Keep track of your medication. Since it’s so important to control your COPD, make sure you always know how much medicine you have left. Get refills on time. You never want to run out unexpectedly. And if you take more than one prescription, take care to keep them straight.

Portable Oxygen Therapy

Many people with COPD need extra oxygen. Some are anxious about traveling with oxygen tanks, though, so they stay home instead of enjoying time away. There’s another option: Portable oxygen concentrators (POCs) take air from the room and convert it into concentrated oxygen. Most are lightweight, compact, and unlike traditional tanks, do not need refilling.

POCs run on batteries. Some can last more than 12 hours. POCs also have AC/DC adapters, so you can plug them into your car or any outlet.

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Traveling With Oxygen

First, ask your doctor if it’s safe for you to travel. Let them know about your travel destination, especially if you are going to higher altitudes or other countries.

Here are a few pointers to keep in mind:

  • Never store tanks in your car’s trunk or in direct sunlight. Keep them away from intense heat.
  • Make sure your tanks have more than enough oxygen for the whole trip and to get you back home. Or plan ahead to get refills. Your supplier can help you with this.
  • Avoid smokers.
  • Make sure your equipment works well before heading out.
  • If traveling by train, bus, or cruise ship, ask about their policies on portable oxygen beforehand.

You must make arrangements ahead of time when flying. When you make your reservation, ask the airline about its policies on portable oxygen.

  • Most U.S. airlines require at least a 48-hour notice, but others need longer. Always check with your airline well before your travel date. Foreign airlines may have different requirements.
  • Find out which POCs are approved by the Federal Aviation Administration (FAA). You can’t bring your POC on the plane unless your airline approves it.
  • If you don’t have an FAA-approved POC, ask if you can rent one.
  • Try to get a nonstop or direct flight to prevent worries about layovers or missing a connecting flight.
  • Some airlines may provide oxygen for a fee.
  • Ask your insurance company whether you need supplementary coverage for traveling with oxygen.
  • Get a prescription for supplemental oxygen from your doctor, and keep this with you -- always. This prescription should state your medical condition and your need for in-flight oxygen and also give specifics on how long oxygen should be used and on the oxygen flow rate.
  • The airlines may have their own forms for your doctor to fill out, so be sure to get these back from your doctor in plenty of time.
  • You might need an increase in the oxygen flow rate during air travel; your doctor will know. Be sure to talk to the doctor about this so you have no discomfort breathing during the flight.
  • The airlines may require you to bring ample batteries to power your POC. Most airlines require that your batteries last 50% longer (or 3 hours longer, in the case of some airlines) than the total time of your trip -- from the time you leave your home until you get to your final destination.
  • Some airlines may allow empty tanks to be stowed, but filled ones are not allowed aboard.
WebMD Medical Reference Reviewed by Dan Brennan, MD on June 12, 2020

Sources

SOURCES:

Norman Edelman, MD, chief medical officer, American Lung Association.

Gail Weinmann, MD, deputy director, NHLBI’s Division of Lung Diseases, Washington D.C.

American Association for Respiratory Care.

American Lung Association, “Supplemental Oxygen.”

Global Initiative for Chronic Obstructive Lung Disease.

National Heart, Lung, and Blood Institute.

National Jewish Health.

National Lung Health Education Program.

American College of Chest Physicians: “Traveling with Portable Oxygen.”

Airline Oxygen Council of America.

U.S. Transportation Security Administration: “Portable Oxygen.”

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