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Bronchodilators

Anti-Inflammatory drugs

Combination Medicines

Antibiotics

Inhaler Technique

Preventative Measures

Other Treatments

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Treatment and Management of COPD and Alpha1 Antitrypsin Deficiency

The most common treatments are with medication to help you breathe easier and by making lifestyle changes. Click on one of the topics in the side panel to learn more.

Medication

There are several types of medications used in controlling the symptoms of COPD. To identify your current medication, click the link below and view our inhaler chart. You can then read about each category of treatment in the list below.

Click here to identify your inhaler

Bronchodilators

These medications are used to relax tight airway muscles. Short acting preparations are available for quick relief. Long acting preparations (controllers) help prevent symptoms of shortness of breath so you can manage your daily activities.

Medication
Use/Action
Common side effects

Short acting Beta2 agonists

ventolinbricanylAiromir

Ventolin® (Salbutamol)
Bricanyl® (Terbutaline)
Airomir® (Salbutamol)

For acute attacks, provides quick relief

Relaxes tightened airway muscles within 5 minutes

Effects lasting 4 hours

May experience shakiness, nervousness, fast heart rate when first taken

Headache if taken frequently

Short Acting Anticholinergics

Atrovent® (Ipratropium bromide)

Slow action, 30-60 minutes before relief is felt

Relaxes tightened airway muscles

Usually prescribed for regular use

May cause dry mouth, metallic taste

Notify doctor if you have glaucoma

Long Acting Beta2 agonists

Serevent® (Salmeterol)
Oxeze® (Formoterol)

Salmeterol relaxes the airway muscles within 20-30 minutes and last up to 12 hours

Formoterol relaxes airway muscles within 3 minutes and last 12 hours.

Do not use Serevent® for quick relief
-tremors, headache, fast
heart rate

If sensitive to the drug, may develop rash, feel itchy or have breathing problems.

Long Acting Anticholinergics

Spiriva® (Tiotropium bromide)

This medication is taken once a day to treat bronchitis and emphysema (COPD)

Relaxes airway muscles and lasts 24 hours

Wash hands after use to
prevent medication getting into eyes.

Headache, dry mouth, skin rash, constipation

Use with caution in bladder or prostate problems

Upset stomach, rash tremors, headache, diarrhea, problem sleeping

Take with food

Do not chew / crush tablets.

 

Anti-inflammatory drugs

This group of medications provides long-term control for some people with COPD Your doctor will decide if this group of medication will benefit you. If prescribed it should be taken exactly as prescribed.

Medication
Use/Action
Common side effects

Anti-Inflammatory drugs

Qvar® (Beclomethasone dipropionate)
Pulmicort® (Budesonide)
Flovent® (Fluticasone propionate)
Alvesco® (Ciclesonide)

Slow action

Prevent swelling and reduces mucus secretions in the airways

Prevents twitchiness of the airways

Hoarseness or oral thrush

Rinsing mouth after use will reduce the risk of side effects

May use with an Aerochamber® with an aerosol inhaler to reduce possibility of side effects

 

Combination Medicines

Inhaled steroid and long acting bronchodilator in one inhaler.

Medication
Use/Action
Common side effects

Combination Medicines


Advair® (Fluticasone+Salmeterol)
Symbicort® (Budesonide/Formoterol Fumarate)

Reduce and prevent airway inflammation

Relax airway muscles for 12 hours

Relief from Advair within 10-15 minutes

Relief from Symbicort® within 3 minutes

 

Anti-inflammatory and long acting bronchodilator in one inhaler

Rinse mouth after use to prevent oral thrush

Symbicort has the advantage of using the same inhaler for adjusting the dose for an Action plan

 

Antibiotics

Antibiotics are used to treat chest infection.

 

Inhaler Technique

Inhalers are designed to send medicine directly to your lungs where it is needed. One advantage of this is that you usually need less medicine compared to oral doses (pills or liquids). Less medicine means fewer side effects. Initially the inhalers may be more difficult to use compared to swallowing pills. However, once you are comfortable using them, they become very routine. By learning to use them properly, you can better control your symptoms by getting the proper dose to your lungs. It is important that you make sure you are taking your medication properly. Ask your pharmacist or healthcare provider to check whether you are using your inhaler properly.

For a detailed description of inhaler techniques, click_here visit the Toronto Western Hospital’s education page on this topic.

 

Preventative Measures

Although there is no cure for COPD, the focus is aimed at improving the quality of life. This can be achieved by:

1) Smoking cessation. This is the most important thing you can do to prevent further lung damage. Several methods are available to help you quit smoking such as .Nicotine patche nicotine gum, nicotine inhaler Tablets are also available Zyban® (bupropion hydrochloride) or Champix® (Varencline), Many successful ex-smokers quit smoking by themselves after realizing the harmful effects on their health. Talk to your doctor about quitting and ask for help from smoking cessation programs

2) Vaccination. Vaccination is important to prevent chest infection caused by influenza and pneumonia. Annual flu shots are recommended. Talk to your doctor about having these.

3) Pulmonary rehabilitation programs. Attending a rehabilitation program will help you cope with daily activities and manage shortness of breath. Some strategies to cope with shortness of breath include learning breathing exercises and relaxation techniques to reduce anxiety. Good nutrition is important for general health. It is important to keep active so you can manage your daily activities.

4) Oxygen therapy. This may be useful in some cases to assist with the activities of daily living and prolong life. You doctor will decide if this would benefit you.

5) Prolastin – Intravenous injection of a purified blood product has been approved for prescription use and is targeted at deficient subjects who have evidence of significant pulmonary disease. However, the role of this replacement therapy remains controversial. Click here for more information about Prolastin

6) Surgery. In special cases lung reduction surgery is done to remove a portion of the lungs with over distended air sacs to make room for the lungs to expand. Often, however the lung damage is often diffuse with little good lung left to improve lung function. Lung and liver transplants are also options when either organ is no longer functioning properly.

7) Know when to seek help. Prevent hospitalization and emergency room visits by having an action plan in place and keep regular follow up visits with your healthcare provider.

Example of an Action Plan