COPD (Chronic Obstructive Pulmonary Disease) (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
- COPD (chronic obstructive pulmonary disease) definition and facts
- What is the definition of chronic obstructive pulmonary disease (COPD)?
- What are the signs and symptoms of COPD?
- What causes COPD?
- What are the risk factors for developing COPD?
- What are the four stages of COPD?
- What other diseases or conditions contribute to COPD?
- How is the diagnosis of COPD made?
- What is the treatment for COPD?
- What lifestyle changes (diet, exercise) and home remedies and care are recommended for people with COPD?
- What medications treat COPD?
- What other supplemental therapies help treat COPD complications and symptoms?
- What surgery is available to treat COPD?
- When to Seek Medical Care for COPD
- Can COPD be prevented?
- What is the prognosis for a person with COPD?
- Which types of doctors treat COPD?
- COPD (Chronic Obstructive Pulmonary Disease) FAQs
- Find a local Pulmonologist in your town
What is the treatment for COPD?
There are many treatments for chronic obstructive pulmonary disease. The first and best is to stop smoking immediately.
Medical treatments of chronic obstructive pulmonary disease include beta-2 agonists and anticholinergic agents (bronchodilators), steroids, mucolytic agents, oxygen therapy, and surgical procedures such as bullectomy, lung volume reduction surgery, and lung transplantation.
The treatments are often based on the stage of chronic obstructive pulmonary disease, for example:
- Stage I - short-acting bronchodilator as needed
- Stage II - short-acting bronchodilator as needed and long-acting bronchodilators plus cardiopulmonary rehabilitation
- Stage III - short-acting bronchodilator as needed long-acting bronchodilators cardiopulmonary rehabilitation and inhaled glucocorticoids for repeated exacerbations
- Stage IV - as needed, long-acting bronchodilators, cardiopulmonary rehabilitation, inhaled glucocorticoids, long-term oxygen therapy, possible lung volume reduction surgery and possible lung transplantation (stage IV has been termed "end-stage" chronic obstructive pulmonary disease)
The three major goals of the comprehensive treatment and management of chronic obstructive pulmonary disease are:
- Lessen airflow limitation
- Prevent and treat secondary medical complications (for example, hypoxemia, infection)
- Decrease respiratory symptoms and improve quality of life
Acute exacerbation of chronic obstructive pulmonary disease is one of the major reasons for hospital admission in the United States.
The patient may need to be hospitalized if they develop severe respiratory dysfunction, if the disease progresses, or if they have other serious respiratory diseases (for example, pneumonia, acute bronchitis). The purpose of hospitalization is to treat symptoms and to prevent further deterioration.
The patient may be admitted to an intensive care unit (ICU) if they require invasive or noninvasive mechanical ventilation or if they have the following symptoms:
- Respiratory muscle fatigue
- Worsening hypoxemia (not enough oxygen in the blood)
- Respiratory acidosis (retention of carbon dioxide in the blood)
What lifestyle changes (diet, exercise) and home remedies and care are recommended for people with COPD?
- The most effective and preventative therapy for chronic obstructive pulmonary disease is to avoid contact with tobacco smoke. If you use tobacco products - quit.
Exercise for COPD
- If a person with chronic obstructive pulmonary disease has mild to moderate symptoms, often they can benefit from exercise programs that can increase their stamina and slow the advancing pace of COPD disease.
Diet, Supplements, Therapy, and Complementary Medicine for COPD
A number of over-the-counter (OTC) supplements and foods are reportedly helpful in reducing symptoms of chronic obstructive pulmonary disease. Home remedies for COPD include:
- Vitamin E to improve lung function
- Omega-3 fatty acids to decrease inflammation (found in supplements or foods such as salmon, herring, mackerel, sardines, soybeans, canola oil)
- Antioxidants to reduce inflammation (found in kale, tomatoes, broccoli, green tea, red grapes)
- Breathing techniques relaxation therapy, meditation
- Acupuncture COPD symptom reduction by needle placement
The person with COPD should discuss the use of any home remedies or supplements with their physician before beginning such treatments because some treatments may interfere with ongoing therapy.
What medications treat COPD?
Nicotine Replacement Therapy
The first line of therapy that involves medication is related to smoking cessation with nicotine replacement therapy. Nicotine replacement therapy can help patients quit smoking tobacco because it can help reduce the withdrawal symptoms due to nicotine. Replacement therapies include nicotine-containing chewing gum and patches that allow nicotine to be absorbed through the skin. In these types of therapy, nicotine is gradually reduced. This medication can work well for those patients who are seriously attempting to quit tobacco.
Oral Medications to Quit Smoking (Smoking Cessation)
- Varenicline (Chantix) is an oral medication that is prescribed to promote cessation of smoking. This is also an alternative to try to quit smoking.
- Bupropion (Zyban) is an antidepressant that helps reduce symptoms of nicotine withdrawal.
- Some medications are used "off label" (that is, they are normally prescribed for another condition) to help people quit smoking. These drugs are recommended by the Agency for Healthcare Research and Quality to help smokers kick the habit, but have not been approved by the FDA for this use. These medications include nortriptyline (Pamelor), an older type of antidepressant. It's been found to help smokers double their chances of quitting compared to taking no medicine. Another drug used off label is clonidine (Catapres). Normally used to treat high blood pressure it can help smokers quit.
Bronchodilators are used for COPD treatment because they open up the airway tubes and allow air to more freely pass in and out of the lung tissue. There are both short-term (several hours) and long-term (12 or more hours) types of bronchodilators.
Some short-term bronchodilators include:
- albuterol (Ventolin, Proventil),
- metaproterenol (Alupent),
- levalbuterol (Xopenex), and
- pirbuterol (Maxair).
Some long-term bronchodilators include:
- salmeterol (Serevent),
- formoterol (Foradil),
- arformoterol (Brovana), and
- indacaterol (Arcapta).
Learn more about: Brovana
Anticholinergic bronchodilators include:
- ipratropium (Atrovent),
- tiotropium (Spiriva), and
- aclidinium (Tudorza).
Learn more about: Spiriva
Learn more about: Elixophyllin
Also on the market are combined to drugs using steroids and long-acting bronchodilators. Roflumilast (Daxas, Daliresp) is a new drug that inhibits the enzyme phosphodiesterase type 4, has been utilized in patients with symptoms of chronic bronchitis.
Learn more about: Daliresp
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