Chronic obstructive pulmonary disease (COPD) is a disease that makes it hard to breathe. Narrowed airways can make you cough, wheeze, and feel short of breath. It can affect how you exercise, work, and do other daily activities.
The goal in treating COPD is to help you breathe easier and get you back to your regular activities. Your doctor has a number of options to choose from. You may also wish to try some natural and alternative treatments, but always get your doctor’s OK first.
These medications work quickly to relax the muscles around your airways and ease symptoms like coughing and shortness of breath. You take them through an inhaler. The effects last about 4 to 6 hours. You use them only when you have symptoms or before you exercise.
These drugs can help if you have symptoms only from time to time. Short-acting bronchodilators include:
- Albuterol (ProAir HFA, Ventolin HFA)
- Ipratropium (Atrovent)
- Ipratropium bromide and albuterol (Combivent)
- Levalbuterol (Xopenex HFA)
These medications also relax the muscles around your airways, but their effects last up to 12 hours. You take them with an inhaler every day to prevent symptoms:
- Aclidinium (Tudorza Pressair)
- Arformoterol (Brovana)
- Formoterol (Foradil, Perforomist)
- Indacaterol (Arcapta)
- Salmeterol (Serevent)
- Tiotropium (Spiriva)
Side effects include:
These bring down swelling in your airways. You usually breathe them in through an inhaler. Inhaled steroids can help if you have many COPD flare-ups. You might take steroids as a pill if your symptoms get worse.
Examples of inhaled steroids are:
Some medicines combine a bronchodilator and inhaled steroid. These include:
Phosphodiesterase-4 (PDE-4) Inhibitor
This medicine works like a bronchodilator, but it's less expensive.
Theophylline can help your lungs work better, but it may not control all of your symptoms.
An infection can make your COPD symptoms worse. Your doctor will give you antibiotics to kill the bacteria and treat the infection.
Take all the medicine you're prescribed. If you stop taking the antibiotics too early, the infection could come back.
Pulmonary rehab is a program to help you manage COPD. It can ease shortness of breath, help you exercise more easily, and improve your quality of life. At a hospital or clinic, you'll work with a team of doctors, nurses, dietitians, physical therapists, and respiratory therapists.
During this program, you'll learn how to:
- Keep your lungs healthy
- Exercise without getting short of breath
- Eat right
- Breathe easier
- Feel better emotionally and physically
Severe COPD can prevent you from getting enough air into your lungs. As a result, oxygen levels in your blood can get too low. Therapy increases these levels to help you stay active and healthy.
You breathe in oxygen through a mask or prongs in your nose. It can come from a big home unit, or from a small tank you carry around with you. You might need oxygen all the time or only when you're active.
Intubation and Ventilators
If your symptoms are serious enough, you may need mechanical help to breathe. This involves tracheal intubation and a ventilator.
If your symptoms don’t improve with other treatments within a certain amount of time -- 1 hour is a common guideline -- intubation and mechanical ventilation will be the next treatment offered.
You’ll have a breathing tube (also called a tracheal tube) put into your mouth and down into your windpipe (trachea). Then the tube is connected to the ventilator, a machine that pushes air into your lungs.
You’ll get medicine to ease your discomfort.
While the machine keeps you breathing, your respiratory system -- which has been struggling to work very hard -- can rest. Doctors also will do tests to identify and treat any other problems, such as pneumonia, that caused the flare-up.
If other treatments don't work and your COPD is severe, you might need one of these surgeries to treat it:
- Bullectomy. Air sacs are the tiny pouches in your lungs where oxygen travels into your blood vessels. COPD destroys the walls of these air sacs. When the walls come down, they create large spaces in your lungs called bullae. These bullae make it hard to breathe. Bullectomy is surgery to remove the air spaces and improve the flow of air in your lungs.
- Lung volume reduction surgery. The surgeon removes small pieces of your lungs that COPD has damaged. Removing the damaged parts helps the healthy parts of your lungs expand so they can take in more oxygen.
- Lung transplant . If you have severe lung damage, your doctor can remove your lung and replace it with a healthy one from a donor. This surgery has risks, and you will need to take medicines for the rest of your life to prevent your body from rejecting the new organ.
Herbal Remedies and Alternative Treatments
Though herbs and supplements can't cure COPD, studies show that some may offer relief. Check with your doctor before you take any of these.
NAC (N-Acetylcysteine). NAC is an antioxidant supplement with mixed reviews in studies. Some research says NAC can help your lungs work better. It might also:
- Thin mucus
- Give you less phlegm
- Ease your cough
Other studies say that NAC has little effect on those things and doesn’t stop COPD flare-ups. Research suggests that the supplement may help you have fewer flare-ups.
Ginseng. This popular herb has thousands of years of medical use behind it. Studies have found that ginseng has some promise in treating COPD symptoms. People who took it were able to breathe and exercise more easily.
Vitamin D. When you have COPD, you may not have enough vitamin D. That makes you more likely to get upper respiratory infections, which can make your COPD symptoms worse. Colds can trigger COPD flare-ups.
Doctors aren't sure if higher levels of vitamin D bring fewer flare-ups and help your lungs work better. In some studies, it does. In others, it doesn't.
Your doctor will probably want to check your vitamin D levels. They may suggest supplements if yours are below normal.
Salvia. Also called red sage, Salvia miltiorrhiza is an herb long used in Chinese medicine. Some research says salvia may help protect your lungs during flare-ups.
Echinacea. Some people take this as a supplement to help ward off or ease cold symptoms. Research shows that taking it once you have a cold won’t do much to shorten it. But taking echinacea while you’re well may help keep you from getting sick.
If you have COPD, you may have trouble sleeping. There's mixed research on whether melatonin can help. Some studies say it helps make it easier to breathe, so it's easier to sleep.
Treatment from your doctor is just one part of COPD care. A few changes to your daily life can also help you breathe easier. The most important one is to quit smoking.
Cigarette smoke is the leading cause of COPD, and it can make the disease worse. It may not be easy for you to quit, but there are many ways to get help. Ask your doctor about nicotine replacement, medicine, and counseling.
Once you've quit, try to stay away from anyone else who smokes. Avoid dust and chemical fumes, too. A couple of other things to consider:
- Talk to a dietitian. See what they say about your eating plan. You might need to eat smaller meals more often or take supplements to get the nutrients you need.
- Exercise. This is also important when you have COPD. It strengthens the muscles that help you breathe.
Your doctor can help you design a fitness program that's safe for you. You'll also learn breathing techniques to help you exercise.