Treatment is given in a step-wise manner with little therapy for those who are minimally impaired and a more aggressive approach for those with severe and very severe disease. At any stage of the disease smoking cessation is the single most important intervention if the patient is still smoking. Group sessions with a smoking cessation therapist, nicotine replacement (patch, gum, nasal spray), and certain pharmaceutical agents can all be helpful.
Physicians have become very familiar in recent years with these approaches and should ask the COPD patient at each session about cigarette smoking, as many patients who stop smoking restart the habit during times of stress.
Medications used for COPD
Short acting bronchodilators
- These inhalers contain Albuterol (Ventolin, Proventil, Proair, Xopenex)- onset in minutes and they last for 4-6 hours
- Ipratropum (Atrovent)- onset in 30 minutes lasts up to 6 hours
- Combivent which is a combination of albuterol and ipratropium
Long acting bronchodilators
- These inhaled medications can be taken once or twice a day (Spiriva, Tudorza, Serevent, Foradil, Onbrez, Brovana, Performist)
- Inhaled corticosteroids are given for severe COPD only available in combination with long acting bronchodilators (Advair, Symbicort, Dulera)
- Leukotriene antagonists (Singulair) not indicated for COPD and given only for asthma
- Roflumilast (Daliresp) which is given to those with severe COPD who have had difficulties with exacerbations
Rehabilitation is recommended for patients who are having difficulty with normal daily activities because of shortness of breath and fatigue. A graded exercise program coupled with patient education is offered. Even those with COPD who have advanced disease and are using oxygen can derive benefit from this program.
Not all patients who have COPD need oxygen. The oxygen level can be measured by a simple oxygen meter placed on the finger and if the level is very low your physician will prescribe oxygen use.
Surgery for COPD
Rarely patients who have very advanced COPD can benefit from pulmonary surgery. A specialist (pulmonologist) is able to do one procedure non-invasively. At times a more invasive procedure can be helpful and this procedure is done by a thoracic surgery specialist.
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