There is no cure for COPD, and the permanent damage done to the airways in the lungs by smoke or other irritants is not reversible. With regular medical care and consistent patient compliance with treatments and lifestyle changes, the symptoms of COPD can be minimized and progression of the disease can be slowed. The treatment goal for people living with COPD is to control symptoms to a degree that allows them to feel better and live as normally and actively as possible for as long as possible and to sleep comfortably.
It is also vital to prevent common diseases that can seriously complicate COPD and become life threatening. These include influenza and pneumonia, which may be prevented with vaccines or treated with antibiotics, as appropriate to your case. In conjunction with your professional health care provider, you will develop an individualized treatment plan that best fits your type and severity of COPD and your life style. The most effect treatment plans include a multifaceted approach. This includes preventive care, which is vital in minimizing the symptoms and exacerbations (episodes of worsening) of COPD.
The key treatment and prevention for COPD is to quit smoking. Your health care provider can make suggestions and referrals to smoking cessation techniques and programs. It is also important to asses and eliminate or minimize exposure to potential lung irritants that can also result in the development of COPD. These include air pollution, chemical fumes, dust. Following manufacturer's directions for the safe use of chemicals, including wearing appropriate masks, is vital.
COPD is also treated with medications. After a complete evaluation, your health care provider will decide what medication or combination of medications will work best for you. Prescribed medications may include short-acting or long-acting bronchodilators that are breathed into the lungs directly taken using a device called an inhaler. Bronchodilators help to relax the lower airways in the lungs and open them up to let in more oxygen. Corticosteroids are another class of medications that can be inhaled. They work by reducing airway inflammation.
Moderate to severe COPD, which results in low levels of oxygen in your blood, may also be treated with oxygen therapy, in which extra oxygen (supplemental oxygen) is given for you to breathe through nasal prongs or a mask. Supplemental oxygen can help relieve the shortness of breath and ensure that the vital organs, such as the heart and the brain, get enough oxygen. Concentrations of oxygen and the types of devices used vary depending on the severity of your condition. Your individual condition will also dictate if you will need oxygen at all times or only during certain activities. For example, some people with COPD find they only need supplemental oxygen when there is a high ozone alert (a lot of pollution in the air/poor air quality). Other people may need supplemental oxygen when they travel to the mountains, because areas in high altitudes have less oxygen in the air. Other people with COPD may need supplemental oxygen when participating in activities or to help them sleep better.
Pulmonary rehabilitation is another form of treatment. It can involve a medically supervised exercise program, disease management training, and nutritional and psychological counseling to help improve overall health and quality of life. There are also a variety of surgeries, including lung transplant that may be considered in severe cases.
The list of treatments mentioned in various sources for COPD includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
The first step in getting correct treatment is to get a correct diagnosis. Differential diagnosis list for COPD may include:
Hidden causes of COPD may be incorrectly diagnosed:
Products, offers and promotion categories available for COPD:
Possibly curable types of COPD may include:
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Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment or change in treatment plans.
Some of the different medications used in the treatment of COPD include:
Unlabelled alternative drug treatments for COPD include:
The following are some of the latest treatments for COPD:
These medical statistics relate to hospitals, hospitalization and COPD:
Research quality ratings and patient incidents/safety measures for hospitals and medical facilities in specialties related to COPD:
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Choosing the Best Treatment Hospital: More general information, not necessarily in relation to COPD, on hospital and medical facility performance and surgical care quality:
The following medical news items are relevant to treatment of COPD:
Patients with COPD can help themselves in many ways. They can:
If the patient and medical team develop and adhere to a program of complete respiratory care, disability can be minimized, acute episodes prevented, hospitalizations reduced, and some early deaths avoided. On the other hand, none of the therapies has been shown to slow the progression of the disease, and only oxygen therapy has been shown to increase the survival rate. (Source: excerpt from COPD Treatment: NHLBI)
Home oxygen therapy can improve survival in patients with advanced COPD who have hypoxemia, low blood oxygen levels. This treatment can improve a patient's exercise tolerance and ability to perform on psychological tests which reflect different aspects of brain function and muscle coordination. Increasing the concentration of oxygen in blood also improves the function of the heart and prevents the development of cor pulmonale. Oxygen can also lessen sleeplessness, irritability, headaches, and the overproduction of red blood cells. Continuous oxygen therapy is recommended for patients with low oxygen levels at rest, during exercise, or while sleeping. Many oxygen sources are available for home use; these include tanks of compressed gaseous oxygen or liquid oxygen and devices that concentrate oxygen from room air. However, oxygen is expensive with the cost per patient running into several hundred dollars per month, depending on the type of system and on the locale.
Medications frequently prescribed for COPD patients include:
Bullectomy, or surgical removal of large air spaces called bullae that are filled with stagnant air, may be beneficial in selected patients. Recently, use of lasers to remove bullae has been suggested.
Lung transplantation has been successfully employed in some patients with end-stage COPD. In the hands of an experienced team, the 1-year survival in patients with transplanted lungs is over 70 percent.
Pulmonary rehabilitation programs, along with medical treatment, are useful in certain patients with COPD. The goals are to improve overall physical endurance and generally help to overcome the conditions which cause dyspnea and limit capacity for physical exercise and activities of daily living. General exercise training increases performance, maximum oxygen consumption, and overall sense of well-being. Administration of oxygen and nutritional supplements when necessary can improve respiratory muscle strength. Intermittent mechanical ventilatory support relieves dyspnea and rests respiratory muscles in selected patients. Continuous positive airway pressure (CPAP) is used as an adjunct to weaning from mechanical ventilation to minimize dyspnea during exercise. Relaxation techniques may also reduce the perception of ventilatory effort and dyspnea. Breathing exercises and breathing techniques, such as pursed lips breathing and relaxation, improve functional status.
Keeping air passages reasonably clear of secretions is difficult for patients with advanced COPD. Some commonly used methods for mobilizing and removing secretions are the following:
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Treatment is designed to relieve symptoms and prevent complications. Because most patients with COPD receive outpatient treatment, they need comprehensive teaching to help them comply with therapy and understand the nature of this chronic, progressive disease. If programs in pulmonary rehabilitation are available, encourage patients to enroll.
Urge the patient to stop smoking. Provide smoking cessation counseling or refer him to a program. Avoid other respiratory irritants, such as secondhand smoke, aerosol spray products, and outdoor air pollution. An air conditioner with an air filter in his home may be helpful.
The patient is usually treated with beta-agonist bronchodilators (albuterol or salmeterol), anticholinergic bronchodilators (ipratropium), and corticosteroids (beclomethasone or triamcinolone). These are usually given by metered-dose inhaler, requiring that the patient be taught the correct administration technique.
Antibiotics are used to treat respiratory infections. Stress the need to complete the prescribed course of antibiotic therapy.
Source: Professional Guide to Diseases (Eighth Edition), 2005
The main goal of treatment is to relieve symptoms and prevent complications. Bronchodilators can help alleviate bronchospasm and enhance mucociliary clearance of secretions. Effective coughing, postural drainage, and chest physiotherapy can help mobilize secretions.
Administration of low concentrations of oxygen helps relieve symptoms; arterial blood gas analysis determines oxygen need and helps avoid carbon dioxide narcosis.
Antibiotics help treat respiratory tract infections. Pneumococcal vaccination and annual influenza vaccinations are important preventive measures.
Some patients benefit from inhaled corticosteroids as maintenance therapy. Oral corticosteroids are occasionally needed for acute exacerbations.
Source: Handbook of Diseases, 2003
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