COPD Treatments

1. Smoking cessation. This is the most important thing you can do for your health. Certain medicines such as Chantix or Wellbutrin and nicotine replacement therapy with the patch, gum, or inhaler can help. Your disease will continue to get worse if you continue to smoke regardless of other treatments.

2. Controller medicines. Take daily to prevent problems even when you feel well!

• Long-acting bronchodilator inhalers with both a long-acting beta-agonist and a lung-acting muscarinic antagonist are the recommended first-line therapy to help control symptoms. Examples are Anoro, Stiolto, and Bevespi.
• Triple therapy inhalers such as Trelegy combine a long-acting bronchodilator inhaler and an inhaled steroid. This is for people who continue to have problems with long-acting bronchodilator inhalers.
• Daily antibiotics such as azithromycin.
• Roflumilast can help with severe COPD.

3. Exercise. This is the most effective treatment for shortness of breath. Formal exercise classes at the hospital are called pulmonary rehabilitation.

4. Oxygen therapy. Keeping your oxygen levels 89% or higher at all times, even with activity and when you are sleeping, helps treat COPD.

5. Immunizations. Get a flu shot yearly, and a pneumonia shot every 5 years.

COPD Exacerbations

Even when patients with COPD do everything right – stop smoking, take their medicines, exercise – they can develop symptoms of coughing, wheezing, and shortness of breath. These are called COPD exacerbations. Exacerbations can be caused by infections, pollution, or allergies. If you develop these symptoms, use the following medications:

• A rescue inhaler or nebulizer with albuterol and/or ipratropium up to every 2 hours.
• An oral steroid such as prednisone for several days.
• An antibiotic such as amoxicillin, azithromycin, or levofloxacin.

Keep doses of exacerbation medications at home. You can never predict when you are going to have an exacerbation.