Inhaled medications are commonly used for treating COPD.
Chronic obstructive pulmonary disease is a progressive lung disorder characterized by airway inflammation, impaired breathing, lung overinflation and impaired exchange of oxygen and carbon dioxide. Cough, increased phlegm production, shortness of breath, difficulty exercising and disrupted sleep are among the symptoms. Several classes of medications are commonly used to treat COPD. Some of these drugs are used daily while others may only be needed during periodic flare-ups.
Medications that widen your airways are called bronchodilators. Beta agonists and anticholinergics are two types of bronchodilators. These medicines work by attaching to receptors in the muscles surrounding your airways, relaxing them and increasing airflow. According to the authors of a study published in the September 2006 issue of "Chest," bronchodilators enhance lung function, increase exercise tolerance, reduce lung overinflation and improve quality of life for people with COPD.
Most bronchodilators -- such as albuterol (Proventil, Ventolin), salmeterol (Serevent), ipratropium (Atrovent) or tiotropium (Spiriva) -- are administered with handheld inhalers or through nebulizers, which are machines that mix medications with water vapor to form an aerosol. Many of these medications can also be taken in pill form or intravenously.
Methylxanthines, including theophylline (Elixophyllin, Theolair) and aminophylline (Truphylline), are caffeine-like drugs that have been used for decades for treating COPD. A 2013 review by the Global Initiative for Chronic Obstructive Lung Disease reports several possible mechanisms by which these drugs may work, including a mild bronchodilation, reduced inflammation and potential strengthening of the respiratory muscles. Methylxanthines can be taken in pill form or given intravenously.
Due to their lower potency and higher potential for serious side effects, such as seizures and abnormal heart rhythms, methlyxanthines are seldom used as the primary therapy for COPD if beta agonists or anticholinergics are available and affordable. These medications, however, may be prescribed in combination with other drugs for people with severe COPD.
Inflammation plays a major role in the development and progression of COPD and perpetuates many of its symptoms. Corticosteroids improve airflow and reduce symptoms by reducing inflammation in your airways and lung tissue. Corticosteroids also help decrease the frequency of COPD flare-ups.
Some corticosteroids, such as prednisone (Sterapred) and methylprednisolone (Medrol), are taken orally. Methylprednisolone can also be administered intravenously or injected into a muscle. Others corticosteroids -- including mometasone (Asmanex), fluticasone (Flovent), beclomethasone (Qvar) and budesonide (Pulmicort) -- are administered with handheld inhalers or nebulizers.
Roflumilast (Daliresp) belongs to a class of antiinflammatory medications called phosphdiesterase-4 inhibitors. It is usually prescribed to reduce the frequency of COPD flare-ups. Roflumilast is a once-daily pill that is typically used with a long-acting bronchodilator. It can also be prescribed in conjunction with corticosteroids because these medications reduce airway inflammation through different mechanisms. An common side effect of roflumilast is weight loss, which is often already a problem for people with COPD patients. Your doctor will monitor your weight if you're taking roflumilast.
Your doctor may prescribe other drugs and therapies to treat COPD. During flare-ups -- and for some people with stable but advanced disease -- supplemental oxygen may be needed. If you develop a bacterial infection that worsens your symptoms, your doctor may prescribe antibiotics. Your doctor may also recommend vaccinations to prevent lung infections.
Because COPD is a progressive disease punctuated by periodic flare-ups, your treatment plan may change frequently and you may need to use multiple medications to control your symptoms. Even if your COPD is stable, you should regularly review your treatment plan with your doctor.