Managing COPD: Medicines for Long-term Control

You may need several types of medicine to control your COPD symptoms. These medicines are inhaled bronchodilators and corticosteroids. They are given using inhalers or nebulizers.

Severity of symptoms

Your treatment is based on how severe your symptoms are. For example, if you have mild to moderate COPD, you may have shortness of breath once in a while. It may not get in the way of your daily activities. If you have moderate to severe COPD, you may have shortness of breath all day. This can make it difficult to walk even a few steps.

• Mild to moderate COPD. You may need short-acting medicines only once in a while, when your symptoms get worse. These medicines give quick relief from symptoms. They do not keep symptoms from happening again.

• Moderate to severe COPD. You will need to take medicine for long-term control if you have more severe symptoms and flare-ups. This is especially true if you need to stay in the hospital for a flare-up. You may also take short-acting medicines regularly. Or you may use these if your symptoms get worse, even with long-term control medicines. You may also need other medicines such as antibiotics or corticosteroids by mouth if you have flare-ups. Antibiotics fight bacterial infections. Corticosteroids help ease swelling in your airways.

Long-term control medicines

Long-term control medicines work over a longer period of time and help to stop symptoms of COPD. They take longer to work, but they may last for 12 to 24 hours. Short-acting medicines work faster, but they may last for only 4 to 6 hours. You take most of these medicines with an inhaler or a nebulizer. You take some medicines by mouth.

Bronchodilators

These medicines help relax the muscles around your airways so that they open up and allow more air through. There are both long-acting and short-acting bronchodilators. Here are types of long-acting bronchodilators.

Type of medicine	Examples	What it does	How it is taken	Notes
Beta 2-agonists	formoterol salmeterol	Help relax the muscles around your smaller airways so you can breathe more easily	Inhaler or nebulizer	There are also short-acting forms for quick relief
Anticholinergics	tiotropium	Help relax the muscles around your large airways so you can breathe more easily	Inhaler or nebulizer	There are also short-acting forms for quick relief
Methylxanthines	theophylline	Help relax your airway muscles. They may also ease swelling in your lungs so you can breathe more easily.	By mouth	Not often prescribed

Inhaled corticosteroids

These medicines help ease swelling in your airways. Examples are beclomethasone, budesonide, and fluticasone. They come as prefilled inhalers or as medicines taken by nebulizer.

Combination medicines

There are also combinations of medicines that may be taken with an inhaler or a nebulizer.

Taking your medicines

To get the relief you need, it's important to take your medicines correctly. Your healthcare provider or pharmacist can help. Also make sure to:

• Use reminders to take your medicines on time. Keep them in a place where you spend a lot of time so that you will see them and be reminded.

• It is a good idea to regularly look at how to correctly use your inhaler and nebulizer.

• All medicines have side effects. Know what to expect and which side effects to tell your provider about.

• Get refills on time so that you don't run out of any of your medicines. When you travel, keep your medicines with you. Bring extra doses in case your return is delayed.

• Make a list of all of your medicines, including all of your inhaled medicines. Include the name, dose, why you take it, and when you take it. Make sure the list is always up-to-date.

• Take your medicines or the list to each doctor’s appointment. Remember to update the medicine list and all copies after your visit. Be sure to add the date the list was last updated.

• Consider wearing a medical alert bracelet or necklace.

Sample medicine list

Your name: _____________________________ Date: _______________________
Medicine name	Dose	When to take	Purpose
Nebulizer medicine 1	0.25 mg/mL	Every 4 hours	Ease airway swelling
Inhaler medicine 1	25 mcg	Every 4 hours	Relax airway muscles
Pill 1	200 mg	Every 4 hours, as needed	Pain relief

 

Using an inhaler

You may use an inhaler for some of your medicines. The inhaler sends the medicine directly into your lungs. Make sure you know how to use your inhaler correctly. If you need help, ask your healthcare provider, nurse, or pharmacist.

 

Using a nebulizer

You may also use a nebulizer for some of your medicines. A nebulizer is a machine that sends medicine directly into your lungs. You add medicine to the nebulizer. It creates a fine mist that you breathe in using a mouthpiece or a mask. You can find the nebulizer at a medical supply company. The company will teach you how to use it. It is very important to clean the equipment and change the supplies as you are told. This is to make sure you don’t breathe in any germs.