Untreated, COPD symptoms may become more severe and disruptive.
Chronic obstructive pulmonary disease, or COPD, takes decades to develop. Continued inflammatory attacks on the lungs and airways—such as from smoking—lead to damage in the air sacs or bronchial tubes that cannot be reversed.
“COPD cannot be cured. It is a chronic disease, so once you have it, you have it,” says Margarita Oks, pulmonologist at Lenox Hill Hospital, Northwell Health.
However, COPD is also a progressive disease. Symptoms of COPD, such as shortness of breath and coughing with mucus, may get worse over time if not effectively managed. For this reason, treatment is incredibly important to avoid more severe symptoms and other health complications.
“The goal of treatment is to keep the disease as stable as possible—to make sure that it does not progress, that your lung function does not deteriorate, and [that] we can maintain a person’s daytime functioning,” says Dr. Oks.
There are several treatment options available for COPD to meet these goals.
“The mainstay treatment options are bronchodilators,” says Dr. Oks. “These are medications that reduce the inflammation in the airways and make it easier for you to breathe.”
Bronchodilators are typically in the form of inhalers, and there are two types for COPD, according to the American Lung Association (ALA):
Beta-agonists mainly relax the muscles to ease breathing. They come in a short-acting form (for quick but short relief) and a long-acting form (for slow but long relief, such as overnight).
Anticholinergics help keep the muscles from tightening, as well as help keep mucus out of the lungs to make it easier to cough and clear out mucus. As with beta-agonists, anticholinergics are available in both short-acting and long-acting forms.
Steroids, or corticosteroids, are an anti-inflammatory medication that can be either inhaled or taken as a pill. In addition to reducing inflammation, they also decrease the amount of mucus production in the airways, since fluid production is a byproduct of inflammation.
While steroids for COPD are very strong and highly effective at relieving symptoms, they are typically only used temporarily and for extreme or special circumstances, as they come with more severe side effects. For example, they may be used if someone is sick and it’s exacerbating their COPD, according to Dr. Oks.
Steroids may also be used in combination with a bronchodilator, and they can be taken at once in the same inhaler.
Oxygen therapy uses an external device that supplies supplemental oxygen through a face mask or nasal prongs. While oxygen equipment is commonly associated with COPD, not everyone with COPD will need oxygen therapy. It’s typically only used for more severe cases of COPD, according to Dr. Oks.
Pulmonary rehabilitation is a formal program that includes education on the condition, exercise training, and nutrition advice, according to the ALA. This program is useful for anyone with a chronic lung disease, including COPD, and it’s recommended for people whose symptoms are seriously limiting their everyday life.
“This is absolutely a livable disease, so while it is a disease, and you have to take care of yourself when you have it, it’s definitely something that you can live with,” says Dr. Oks.
Dr. Oks is a pulmonologist at Lenox Hill Hospital and Northwell Health. She is triple board-certified in Internal Medicine, Critical Care Medicine, and Pulmonary Disease.
00:00:01,103 --> 00:00:04,297
COPD cannot be cured,
it is a chronic disease.
00:00:04,297 --> 00:00:06,717
So once you have it, you have it.
00:00:06,717 --> 00:00:11,859
Now the goal of treatment is to keep
the disease as stable as possible to
00:00:11,859 --> 00:00:17,890
make sure that it does not progress that
your lung function does not deteriorate.
00:00:17,890 --> 00:00:21,122
And we can maintain a person's
daytime functioning and
00:00:21,122 --> 00:00:23,952
their ability to do their
daily everyday tasks.
00:00:23,952 --> 00:00:29,430
00:00:29,430 --> 00:00:32,747
The mainstream treatment
option are bronchodilators and
00:00:32,747 --> 00:00:36,739
these are medications that reduce
the inflammation in the airways and
00:00:36,739 --> 00:00:38,710
make it easier for you to breathe.
00:00:38,710 --> 00:00:40,712
There's two different types.
00:00:40,712 --> 00:00:43,172
There are beta-agonist and
00:00:43,172 --> 00:00:47,335
They reduce inflammation in the airways
and they open up the airway,
00:00:47,335 --> 00:00:50,149
so a person can take deeper breaths in and
00:00:50,149 --> 00:00:52,175
Steroids reduce inflammation,
00:00:52,175 --> 00:00:57,252
they're a stronger medication because
it's not an inhaler, it's orally used.
00:00:57,252 --> 00:01:02,124
Most of the time we use them when
somebody has refractory disease and
00:01:02,124 --> 00:01:07,521
we can control their symptoms with
inhalers or we use it in exacerbations.
00:01:07,521 --> 00:01:11,581
When somebody get sick, and they have
COPD, and there's an exacerbation of their
00:01:11,581 --> 00:01:15,061
bronchitis or emphysema that's where
steroids are the most helpful.
00:01:15,061 --> 00:01:17,181
They're also supplemental medications.
00:01:17,181 --> 00:01:18,238
So we have oxygen,
00:01:18,238 --> 00:01:21,881
we have pulmonary rehabilitation,
which is a form of exercise.
00:01:21,881 --> 00:01:26,961
So combining a lot of them together,
will improve your functional status.
00:01:26,961 --> 00:01:31,531
Things like oxygen, and prednisone, or
steroids, tend to be used when somebody
00:01:31,531 --> 00:01:35,452
has end stage, or really severe disease,
or during exacerbations.
00:01:35,452 --> 00:01:38,709
But the main stage treatment
00:01:38,709 --> 00:01:42,269
which helps most of the time
in different combinations.
00:01:42,269 --> 00:01:46,730
This is absolutely a livable disease,
so while it is a disease and
00:01:46,730 --> 00:01:50,133
you have to take care of
yourself when you have it,
00:01:50,133 --> 00:01:54,513
it's definitely something that
you can live more than maintain
00:01:54,513 --> 00:01:59,327
a good level of functioning if you
take care of the disease and yourself
Managing your COPD medications. Chicago, IL: American Lung Association. (Accessed on September 12, 2019 at https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/diagnosing-and-treating/managing-your-copd-medications.html.)
Oxygen therapy. Chicago, IL: American Lung Association. (Accessed on September 12, 2019 at https://www.lung.org/lung-health-and-diseases/lung-procedures-and-tests/oxygen-therapy/.)
The basics of pulmonary rehabilitation. Chicago, IL: American Lung Association. (Accessed on September 12, 2019 at https://www.lung.org/lung-health-and-diseases/lung-procedures-and-tests/pulmonary-rehab.html.)
What is COPD? Miami, FL: COPD Foundation. (Accessed on September 13, 2019 at https://www.copdfoundation.org/What-is-COPD/Understanding-COPD/What-is-COPD.aspx.)