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COPD

Treatment Overview

Although COPD cannot be cured, it can be managed. The goals of treatment are to:

Slow down the disease by avoiding tobacco smoke and air pollution.
Limit your symptoms, such as shortness of breath.
Increase your activity level.
Improve your overall health.
Prevent and treat flare-ups . A flare-up, or exacerbation, is when your symptoms quickly get worse and stay worse.

Many people are able to manage their COPD well enough to take part in their usual daily activities, hobbies, and family events.

Initial treatment

At first, treatment for COPD helps you breathe better and slow the disease. Much of the treatment includes things you do for yourself:

Quit smoking. This is so important. And it's never too late. No matter how long you have had COPD or how serious it is, quitting smoking will help slow down the disease and improve your quality of life. Today's medicines offer lots of help for people who want to quit. You will double your chances of quitting even if medicine is the only treatment you use to quit, but your odds get even better when you combine medicine and other quit strategies, such as counseling.1

For more information, see the topic Quitting Smoking.

Stay active. If you stay active, you may have less shortness of breath, have a better attitude about your life and the disease, and be less likely to feel depressed or isolated from friends and family. Exercise improves shortness of breath and will help you be more active.

Stay healthy. The flu, pneumonia, and other illnesses involving your lungs can make your COPD worse. Do your best to avoid them:
- Wash your hands often.
- Stay away from people who have a cold or the flu.
- Talk with your doctor about getting a yearly flu vaccine and a pneumococcal shot. If you've already had one pneumococcal shot, ask your doctor if you should have a second shot. Sometimes a second shot is advised for people who got their first shot when they were younger than 65.
Eat regularly and well. Muscle weakness and weight loss are common with severe COPD. And they make it harder for your body to fight the disease.

Avoid triggers. Stay away from things that can trigger a flare-up, including indoor and outdoor air pollution, cold dry air, hot humid air, and high altitudes.

Learn how to breathe. Learn ways to breathe that improve airflow in and out of your lungs. Learn ways to clear your lungs to save energy and oxygen.

Rest often. Take rest breaks during household chores and other activities. Talk to an occupational or physical therapist about finding ways to do everyday activities with less effort.

Oxygen treatment

Oxygen treatment is mainly used to prevent right-sided heart failure or keep it from getting worse.

Medicines

Bronchodilators. These medicines open the bronchial tubes, which are your lungs' airways. This helps you breathe better. The medicines are either short-acting to help relieve your symptoms or long-acting to help prevent them.
Anti-inflammatory medicines such as corticosteroids. These may be pills that you take or medicine that you inhale. Inhaled medicines are used with an inhaler, which delivers more medicine directly to the lungs. If you use an inhaler, make sure that you know how to use it properly.

Expectorants. These medicines may make it easier to cough up mucus, but they are no longer commonly used.

Education and support

Treatment should also include:

Education. Educating yourself and your family about COPD and your treatment plan helps you and your family cope with your disease.
Counseling and support groups. Shortness of breath may lower your activity level. That can make you feel sad and alone because you cannot enjoy activities with your family and friends. But you should be able to lead a full life, including being sexually active. Counseling and support groups can help both you and your family.
Building a support network of family and friends. Learning that you have a disease that may shorten your life may cause depression or grief. Anxiety can make your symptoms worse and can cause flare-ups and make them last longer. Support from family and friends can lower your anxiety and stress.

Ongoing treatment

COPD flare-ups

COPD flare-ups, or exacerbations, are when your symptoms-shortness of breath, cough, and mucus production-quickly get worse and stay worse.

Work with your doctor to make a plan for dealing with a COPD flare-up. If you are prepared, you may be able to get it under control. Do not panic if you start to have one. Quick treatment at home may help you prevent serious breathing problems.

A flare-up can be life-threatening, and you may need to go to your doctor’s office or to a hospital. Treatment for flare-ups includes:

Medicines to help you breathe.
Anticholinergics (ipratropium, tiotropium)
Oral corticosteroids (prednisone, methylprednisolone)
Beta2-agonists (albuterol, metaproterenol)
Machines to help you breathe. The use of a machine to help with breathing is called mechanical ventilation. Ventilation is used only if medicine is not helping you and your breathing is getting very difficult.
Noninvasive positive pressure ventilation (NPPV) forces air into your lungs through a face mask.
With invasive ventilation, a breathing tube is inserted into your windpipe, and a machine forces air into your lungs.
Oxygen to help you breathe. Oxygen treatment involves getting extra oxygen through a face mask or through a small tube that fits just inside your nose. This can be done in the hospital or at home. For more information, see:
Other ongoing treatment
Treatment for depression. COPD can affect more than your lungs. It can cause stress, anxiety, and depression. These things take energy and can make your COPD symptoms worse. But anxiety and depression can be treated with counseling and medicine. If you feel very sad or anxious, call your doctor.
Treatment for muscle weakness and weight loss. Many people with severe COPD have trouble keeping their weight up and their bodies strong. This can be treated by paying attention to eating regularly and well.
Pulmonary rehabilitation. Your doctor may also suggest a rehab program that is just for people with lung problems. It includes activities such as exercise and breath training.

Antibiotics. These medicines are used when a bacterial lung infection is considered likely. People with COPD have a higher risk of pneumonia and frequent lung infections. These infections often lead to COPD exacerbations, or flare-ups, so it's important to try to avoid them.

Treatment if the condition gets worse

As COPD gets worse, you may have more shortness of breath and more flare-ups. It will become harder to do your daily activities. A pulmonary rehabilitation program, which includes activities such as exercise and breath training, can help make it possible for you to do your daily activities.

Other treatment includes:

Medicines such as methylxanthines or oral corticosteroids.
Oxygen treatment, which increases the amount of oxygen in the blood and lungs. This may improve shortness of breath and help people with severe COPD live longer.
Surgery, which is not common. There are several types of surgery for severe COPD:
- Lung volume reduction surgery removes part of one or both lungs, making room for the remaining lungs to work better.
- Lung transplant replaces a diseased lung with a living lung from a person who has recently died.
- Bullectomy removes bullae from the lungs in those who mainly have emphysema. Bullae are formed when the tiny air sacs in the lungs break into larger air spaces. They sometimes can become so large that they interfere with breathing.

Heart failure that affects the right side of the heart, called cor pulmonale, often occurs in people with COPD. Treatment may include oxygen and diuretic medicine.

What to think about

Treatment for COPD is getting better all the time. But COPD is a disease that keeps getting worse and can be fatal. You and your doctor should discuss what types of treatment you want if sudden, life-threatening breathing problems occur.

This discussion may include writing an advance directive. This is a document that your doctor and family can use if you become unable to tell them what your wishes are. For more information, see the topics:

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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