Managing COPD: Medicines for Long-term Control
You may need several types of medicine to manage your COPD symptoms. These medicines
may include inhaled bronchodilators, corticosteroids, and antibiotics. They are given
using inhalers or nebulizers, or as pills.
Severity of symptoms
Your treatment is based on how severe your symptoms are. For example, if you have
mild to moderate COPD, you may have shortness of breath once in a while. It may not
get in the way of your daily activities. If you have moderate to severe COPD, you
may have shortness of breath all day. This can make it hard to walk even a few steps.
-
Mild to moderate COPD. You may need short-acting "rescue" medicines only once in a while, when your symptoms
get worse. These medicines give quick relief from symptoms. They don't keep symptoms
from happening again.
-
Moderate to severe COPD. You will need to take "maintenance" medicine for long-term control if you have more
severe symptoms and flare-ups. This is especially true if you need to stay in the
hospital for a flare-up. You may also take short-acting rescue medicines regularly.
Or you may use these if your symptoms get worse, even with long-term control medicines.
You may also need other medicines, such as antibiotics or corticosteroids, by mouth
if you have flare-ups. Antibiotics fight bacterial infections. Corticosteroids help
ease inflammation and swelling in your airways. You may also be started on oxygen
at home for a short-term or long-term period.
To prevent lung infections, ask your healthcare provider about flu and pneumonia vaccines.
Also, ask about pulmonary rehab programs. These programs focus on strengthening exercises
and improving your quality of life. Programs may also have health coaches to support
and encourage you.
Long-acting controller medicines
Long-term control medicines work over a longer period of time. They help to control
and prevent symptoms of COPD. They take longer to work, but they may last for 12 to
24 hours. Short-acting medicines work faster, but they may last for only 4 to 6 hours.
You take most of these medicines with an inhaler or a nebulizer. You take some medicines
by mouth.
Always use correct inhaler and nebulizer techniques for your prescribed medicine delivery
system. Refer to the information that came with your medicine from the manufacturer.
Or contact your healthcare provider if you have any questions about how to use the
device, such as a metered-dose inhaler or nebulizer.
Bronchodilators
These medicines help relax the muscles around your airways so that they open up and
allow more air through. There are both long-acting and short-acting bronchodilators.
Here are types of long-acting bronchodilators.
Type of medicine
|
Examples
|
What it does
|
How it is taken
|
Notes
|
Beta 2-agonists
|
formoterol
salmeterol
|
Helps relax the muscles around your smaller airways so you can breathe more easily
|
Inhaler or nebulizer
|
There are also short-acting forms for quick relief
|
Anticholinergics
|
tiotropium
|
Helps relax the muscles around your large airways so you can breathe more easily
|
Inhaler or nebulizer
|
There are also short-acting forms for quick relief
|
Methylxanthines
|
theophylline
|
Helps relax your airway muscles. They may also ease swelling in your lungs so you
can breathe more easily.
|
By mouth
|
Not often prescribed
|
Inhaled corticosteroids
These medicines help ease swelling in your airways. After using corticosteroids in
your inhaler or nebulizer, gargle and rinse out your mouth with water to prevent thrush,
a fungal (yeast) infection. Spit the water out. Don’t swallow the water. If a mask
was used, wash your face, especially around your mouth and nose, with warm water to
prevent a skin rash.
Examples of these medicines are beclomethasone, budesonide, and fluticasone. They
come as prefilled inhalers or as medicines taken by a nebulizer.
Combination medicines
There are also combinations of medicines that may be taken with an inhaler or a nebulizer.
They may be a combination of a corticosteroid and a bronchodilator.
Taking your medicines
To get the relief you need, it's important to take your medicines correctly. Your
healthcare provider or pharmacist can help. Follow these tips:
-
Use reminders to take your medicines on time. You might set an alarm on your phone
or watch. Keep your medicines in a place where you spend a lot of time so that you
will see them and be reminded.
-
Regularly look at how to correctly use your inhaler and nebulizer. Show your technique
to your healthcare provider. It's very important to follow the correct techniques
when using these devices.
-
All medicines have side effects. Know what to expect and which side effects to tell
your provider about.
-
Get refills on time so that you don't run out of any of your medicines. When you travel,
keep your medicines with you. Bring extra doses in case your return is delayed. If
you're flying, keep your medicines in your carry-on bag.
-
Make a list of all your medicines, including all your inhaled medicines. Include the
name, dose, why you take it, and when you take it. Make sure the list is always up-to-date.
-
Take your medicines or the list to each healthcare provider’s appointment and any
hospital visits. Remember to update the medicine list and all copies after your visit.
Be sure to add the date the list was last updated.
-
Consider wearing a medical alert bracelet or necklace.
-
If you smoke, talk to your healthcare provider for help quitting. This includes not
using e-cigarettes. Smoking is a major cause of COPD.
Sample medicine list
Your name: ____________________
Date: ____________________
|
|
|
|
Medicine name
|
Dose
|
When to take
|
Purpose
|
Nebulizer medicine 1
|
0.25 mg/mL
|
Every 4 hours
|
Ease airway swelling
|
Inhaler medicine 1
|
25 mcg
|
Every 4 hours
|
Relax airway muscles
|
Pill 1
|
200 mg
|
Every 4 hours, as needed
|
Pain relief
|
Using an inhaler
You may use an inhaler for some of your medicines. The inhaler sends the medicine
directly into your lungs. Make sure you know how to use your inhaler correctly. If
you need help, ask your healthcare provider, nurse, or pharmacist.
Using your inhaler (no spacer)
A metered-dose inhaler sends a measured amount of medicine to your lungs. The medicine
must be breathed deeply into your lungs for it to work.
Here’s how to use an inhaler:
-
First, wash your hands. Then, check the expiration date and the counter on the inhaler.
Make sure the inhaler still has doses left. Also check that the metal canister is
put correctly into the plastic boot.
-
Remove the cap from the inhaler mouthpiece. Shake the inhaler several times.
-
If this is the first time you are using the inhaler, you need to prime it. That means
making sure it is ready to use. Follow the manufacturer’s instructions. Prime the
inhaler in the air away from your face.
-
The inhaler is now ready to use.
-
Your healthcare provider will tell you whether to use the “closed-mouth” or “open-mouth”
method.
-
Empty your lungs completely by taking a "deep breath in” and tilting your head back
slightly and blowing air out.
-
For the “closed-mouth” method, put the inhaler mouthpiece in your mouth, past your
teeth and above your tongue. Close your lips tightly around the mouthpiece to create
a tight seal so the medicine doesn’t spray in your eyes.
-
Or for the open-mouth method, hold the inhaler up to your mouth, with the mouthpiece
2 finger-widths away from your lips.
-
Make sure you are standing up or sitting up straight in a chair. Always keep your
inhaler at chin level.
-
Press down on the canister 1 time to release the medicine. At the same time, breathe
in deeply and slowly for 3 to 5 seconds.
-
Remove the mouthpiece from your mouth if you are using the closed-mouth method. Or
move it away from your mouth if you are using the open-mouth method. Then, close your
lips.
-
Hold your breath for up to 10 seconds, if you can. Then breathe out slowly through
your mouth.
-
Repeat these steps for each puff of medicine. Wait at least 15 seconds to 1 minute
before taking the next puff, or as long as directed by your healthcare provider.
-
If you’re using a steroid inhaler, gargle and rinse with water to prevent thrush,
a fungal (yeast) infection. Spit the water out. Don’t swallow the water. Clean your
inhaler after every use or at least once a week or as directed by the manufacturer
of the device.
Using your metered-dose inhaler with spacer
-
First, wash your hands. Then, check the expiration date and the counter on the inhaler.
Make sure the inhaler still has doses left. Also check that the metal canister is
put correctly into the plastic boot.
-
Remove the cap from the inhaler. Shake the inhaler several times.
-
If this is the first time you are using the inhaler, you need to prime it. That means
making sure it is ready to use. Follow the manufacturer's instructions. Prime the
inhaler in the air away from your face.
-
The inhaler is now ready to use.
-
Next, remove the cap and look into the mouthpiece of the spacer to make sure nothing
is in it (the spacer).
-
Attach the spacer to the inhaler.
-
Remove the cap from the spacer mouthpiece.
-
Empty your lungs completely by taking a "deep breath in” and tilting your head back
slightly and blowing air out.
-
Put the mouthpiece of the spacer in your mouth, past your teeth and above your tongue.
Make sure your tongue doesn't block the opening of the spacer mouthpiece. Close your
lips tightly around it to create a tight seal.
-
If you are using a spacer with a mask, make sure the mask covers your nose and mouth.
There should be no space between your skin and the mask.
-
Make sure you are standing up or sitting up straight in a chair. Always keep your
chin level.
-
Press down on the canister 1 time to release the medicine. Then breathe in slowly
and deeply until all the medicine in the spacer is gone or as directed by your healthcare
provider. If your spacer has a whistle built in, hearing the whistle means you are
breathing in too quickly.
-
Remove the spacer mouthpiece from your mouth and close your lips.
-
Hold your breath for up to 10 seconds, if you can. Then breathe out slowly through
your mouth.
-
Repeat these steps for each puff of medicine. Wait at least 15 seconds to 1 minute
before taking the next puff, or as long as directed by your healthcare provider.
-
If you’re using a steroid inhaler, rinse and gargle with water to prevent thrush,
a fungal (yeast) infection. Spit the water out. Don’t swallow the water. If a mask
was used, wash your face, especially around your mouth and nose, with warm water to
prevent a skin rash.
-
Clean your inhaler and spacer after every use or at least once a week or as directed
by the manufacturer of the device.
Using a nebulizer
You may also use a nebulizer for some of your medicines. A nebulizer is a machine
that sends medicine directly into your lungs. You add medicine to the nebulizer. It
creates a fine mist that you breathe in using a mouthpiece or a mask. You can find
the nebulizer at a medical supply company. The company or your healthcare provider
will teach you how to use it. It's very important to clean the equipment and change
the supplies as you are told. This is to make sure you don’t breathe in any germs.