Chronic obstructive pulmonary disease (COPD) cannot be cured. Treatment for the ailment focuses on easing breathing, reducing wheezing and coughing and preventing flare-ups that may require hospitalization. Medications used for treating COPD are inhaled, and occasionally taken orally, to help open the airways to facilitate air circulation in the lungs.
How to Treat COPD
Short-acting bronchodilators are primarily recommended for people with stable COPD. Intermittent symptoms of the ailment can be kept under control with the help of bronchodilators such as anticholinergics such as ipratropium and short acting beta2-agonists such as levalbuterol and albuterol. Sometimes, anticholinergics and beta2 agonists are combined to improve breathing.
Persistent breathing problems are kept under control with the help of long-acting bronchodilators. Anticholinergics such as tiotropium and beta-2-agonists such as formoterol, salmeterol and arformoterol, when inhaled, keep the airways open for a longer time.
Phosphodiesterase-4 (PDE4) Inhibitors
Roflumilast is the only PDE4 inhibitor currently available for preventing COPD flare-ups. It is one of the new drugs used in COPD treatment. It is primarily recommended for people with severe COPD and for reducing exacerbation of breathing difficulties in people diagnosed with COPD.
PDE4 inhibitor works by suppressing the activities of the PDE4 enzyme that triggers inflammation of the airways. This drug is taken orally daily to keep the symptoms of COPD under control. Diarrhea, nausea and headache are common side effects of the drug.
Corticosteroids are primarily inhaled and occasionally taken orally for reducing inflammation of the airways in COPD patients. Inhaled corticosteroids commonly used for treatment include budesonide, beclomethasone, mometasone, flunisolide, triamicinolone and fluticasone. These drugs are sometimes used for keeping the symptoms of COPD under control in people with stable COPD.
However, they are primarily used for reducing the episodes of flare-ups in people with severe COPD. Oral corticosteroids such as prednisone, prednisolone and methylprednisolone are usually recommended for treating COPD exacerbation that is accompanied by excess mucus secretion. Some COPD drugs combine corticosteroids with long-acting beta2-agonists. Inhaled corticosteroids are considered safe.
Sore throat and mouth, voice change and oral fungal infection are common side effects of inhaled corticosteroids. Oral corticosteroids increase the risk of weight gain, diabetes, fluid retention, high blood pressure, osteoporosis, cataract, infections, stomach ulcers and mood change.
Occasionally, doctors prescribe expectorants for eliminating mucus from the airways of COPD patients. However, lung function of COPD patients does not improve by taking expectorants. Dizziness, nausea, vomiting, itching and skin rash are common side effects of these drugs.
Methylxanthines attenuates the symptoms of COPD by working as a bronchodilator. Given the serious side effects of these drugs, they are reserved only for treating severe COPD exacerbation. Two methylxanthines commonly used for treating breathing difficulties include aminophylline and theophylline.
In addition to relaxing the airways, these drugs ease removal of mucus from the lungs. Moreover, by strengthening the diaphragm, they improve breathing. Methylxanthines also work on the areas of the brain that control breathing. Rapid breathing, increase in heart rate, nervousness, insomnia, headache, stomach upset and heartburn are common side effects of these drugs.
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