Managing COPD: Medications
For people living with COPD, medications can be used to prevent and control symptoms or reduce the worsening of symptoms. Most people living with COPD take medications on a regular basis to make breathing easier, and other medications are only used as needed when symptoms get worse. Medications prescribed for COPD typically fall into these categories: bronchodilators, corticosteroids, antibiotics and others.
Bronchodilators relax tightened muscles around the airways. Most bronchodilators are given in an inhaled form or in liquid form with a nebulizer. It is important to understand how to use the inhaler properly in order to avoid complications and to ensure that the correct dose of medication is delivered.
There are three types of bronchodilators: beta-agonists, anticholinergics and combination bronchodilators.
1. Beta-agonists make breathing easier and can be short-acting or fast-acting. There are two types of beta-agonists:
| Examples include: albuertol (Proventil® HFA and Ventolin® HFA), levalbuteraol |
(Xopenex®), Pirbuterol (Maxair Autohaler®)
|Examples include: salmeterol (Serevent®), formoterol (Foradil®)|
2. Anticholinergics help open the airways by blocking specific receptors found in the lungs that promote constriction. They may also decrease secretions.
Examples include: ipratropium (Atrovent®) and tiotropium (Spiriva®)
3. Combination short-acting beta-agonist and anticholinergic make breathing easier and can help open the airways.
Examples include: combination albuteral and ipratropium (Combivent®)
Corticosteroids are anti-inflammatory medications, which reduce swelling in the airways. They can be used in inhaler or pill form. They are not prescribed for everyone with COPD, but they can improve symptoms in some people with mild to severe COPD.
Inhaled corticosteroids should be taken regularly to prevent or reduce symptoms and exacerbations (periods when symptoms are worse than normal).
Examples include: beclomethasone (Vanceril® and Beclovent®), budesonide (Pulmicort®), fluticasone (Flovent®), triamcinolone (Azmacort®) and flunisolide (Aerobid®)
Pill corticosteroids are commonly prescrbied for a period of days or weeks to treat COPD exacerbations.
Combination long-acting bronchodilator and anti-inflammatory medications
Combination medications contain both bronchodilator and anti-inflammatory medication in one delivery device. These medications work together reduce and prevent symptoms; the bronchodilator relaxes the tightened muscles around the airway and the anti-inflammatory medication reduces swelling in the airways and mucous production.
Examples include: Advair® (combination of Flovent® and Serevent®) and Symbicort® (combination of Pulmicort® and Foradil®)
Antibiotics are not routinely used in managing COPD, but they can be used to fight a respiratory infection or exacerbation. Your health care provider may order a sputum analysis to help determine if antibiotics are needed.
People who have COPD should take a few extra precautions before beginning any prescription or over-the-counter medications. It is important to discuss any new medications with a health care provider (doctor, pharmacist, nurse, pulmonary rehab staff) to ensure that they are safe to use for people who have COPD and in combination with other COPD medications.