What are the options for COPD Treatment?
While there is no cure for COPD, the goal of COPD treatment is to slow disease progression, reduce symptoms, prevent COPD flare-ups and improve quality of life. If youâ€™re diagnosed with COPD, you can work with your doctor to develop an individualized COPD treatment plan. Depending upon how advanced your disease, your treatment options may include the following:
Smoking cessation â€“ the most important aspect of COPD treatment for anyone with COPD who smokes is to quit smoking. Studies show that a combination of medications (nicotine replacement therapy, Wellbutrin, Chantix, Elavil) and behavioral counseling work best. If you are a non-smoker, you should avoid all airway irritants, such as secondhand smoke, indoor and outdoor air pollution and dust and chemicals in the workplace.
Physical activity â€“ regular exercise is important for people with COPD. Talk with your doctor about what types of activities are best for you. You may find being active has become more difficult with your COPD symptoms. However, staying active can also keep the muscles that help you breathe strongerâ€”and therefore help you breathe more easily.
COPD medications help reduce symptoms and prevent complications. The following are the most common medications given in COPD treatment:
- Bronchodilators relax the breathing passages making it easier to breathe. Depending on the severity of your COPD, your doctor may prescribe short-acting or long-acting bronchodilators, or a combination of the two.
- Corticosteroids reduce inflammation in the air passages. Regular treatment with inhaled corticosteroids improves symptoms and quality of life, increases lung function and reduces the risk of COPD exacerbation. Inhaled corticosteroids can be given alone or in combination with a long-acting bronchodilator.
- Phosphodiesterase-4 inhibitors suppress inflammation by blocking the action of PDE4, an enzyme thatâ€™s overproduced in asthma and COPD. The once-daily medication called Daliresp (romflumilast) is the only PDE4 inhibitor on the market thatâ€™s approved for the treatment of COPD. The drug has been shown to improve forced expiratory volume in one second (FEV1) and reduce the frequency of COPD exacerbations.
- Antibiotics are reserved in COPD treatment for cases of COPD exacerbation that are caused by a bacterial infection. Antibiotics are not effective in treating exacerbations caused by viruses.
Oxygen Therapy for COPD
Another way to treat COPD is with oxygen therapy, delivered through a variety of methods. In all of these methods, the oxygen is administered in one of three ways:
- Through a nasal cannula (small plastic tubes placed in each nostril).
- Through a face mask (which fits over your mouth and nose).
- Through a small tube inserted into your windpipe via an incision in the front of your neck (transtracheal oxygen therapy).
Types of Oxygen Delivery Systems
The type of oxygen delivery system you choose depends upon your individual needs and the advice of your doctor.
- Portable Oxygen Concentrators â€“ For more active people with COPD: portable oxygen concentrators offer more freedom of movement. Theyâ€™re lightweight and continuously purify air from the atmosphere, eliminating the need for tanks or any type of refill. Portable oxygen concentrators are powered by a rechargeable battery or any AC/DC power outlet, so you can travel with them or use them as your main oxygen supply source at home.
- Home Oxygen Concentrators — When treating COPD, oxygen concentrators may be needed. Home oxygen concentrators are inexpensive but fairly heavy (about 30 pounds) and need to be plugged into a power outlet. They work by concentrating oxygen from the air all around you and removing the other gases.
- Compressed Oxygen Tanks and Cylinders â€“ Tanks or cylinders are another option for COPD oxygen therapy. They contain compressed or pressurized oxygen gas and come in different sizes. Some are too heavy to move around, but smaller sized tanks or cylinders can be carried or wheeled in a cart.
- Liquid Oxygen Systems â€“ Liquid oxygen is created by cooling oxygen gas, which changes it to a liquid form. This form of COPD oxygen therapy tends to be used by people who are more active because larger amounts of oxygen can be stored in smaller, more convenient containers than with compressed oxygen tanks.Â Unfortunately, liquid oxygen canâ€™t be stored for a long time because it will evaporate.
Flu and Pneumonia Vaccines
Unless your health care provider informs you otherwise, every COPD patient should get an annual flu vaccine as soon as they become available during the year. An annual flu vaccine reduces the risk of serious illness and death in COPD by as much as 50 percent. Pneumonia vaccines lower the risk of pneumococcal (a type of bacteria) pneumonia and are recommended for COPD patients aged 65 years and older and younger COPD patients who have significant co-existing illnesses such as heart disease and diabetes.
A formal pulmonary rehabilitation program typically includes an exercise program, disease management consultation as well as nutritional and psychological counseling. Your health care professionalsâ€”doctors, nurses, physical therapists, respiratory specialists and nutritionistsâ€”will work together to develop a program designed especially for you. Benefits of pulmonary rehabilitation include improved survival, improved ability to exercise, reduced breathlessness, improved quality of life, reduced hospitalization time and hospitalizations per year, decreased anxiety and depression and improved arm function.
Lung surgery may benefit some people who have COPD and is often a last resort for people with severe symptoms that have not experienced any improvement from other methods of treatment. There are four possible types of surgery that your doctor may recommend: standard lung volume reduction surgery (LVRS), bronchoscopic lung volume reduction (BLVR), lung transplant and bullectomy. Standard LVRS and BLVR are procedures that remove damaged lung tissue from the lungs to help them work better. The main difference between the two is that standard LVRS is done in open surgery while BLVR is done with a bronchoscope. A lung transplant removes the diseased lung and replaces it with a healthy lung from a deceased donor. A bullectomy removes bullae, large air spaces that form when the lungsâ€™ air sacs are destroyed.
Testing for COPD
COPD (Chronic Obstructive Pulmonary Disease) is diagnosed through a basic lung test called spirometry. In this test you blow air into a mouthpiece and an attached machine measures how much air youâ€™re blowing and how quickly you can blow it. The results from this test will help determine your COPD diagnosis and how severe your COPD is.
By Deborah LeaderÂ RN, BSN, PHN