Treating for COPD

Because COPD is a progressive disease, the key is managing and preventing (as best we can) any further complications for whatever stage we are in. The most important complications for COPD are coughing, changes in sputum (color/amount), and fever (and need to be reported to your provider). The most important side effects are those for Streroid therapy; these may include weight gain, diabetes, osteoporosis, cataracts and an increased risk of infection.

1) Lifestyle Changes

-Quit Smoking and Avoid Lung Irritants

Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about programs and products that can help you quit. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Ask your family members and friends to support you in your efforts to quit. Try to avoid secondhand smoke and places with dust, fumes, or other toxic substances that you may inhale.

-Other Lifestyle Changes

If you have COPD, you may have trouble eating enough because of your symptoms, such as shortness of breath and fatigue. (This issue is more common with severe disease.) As a result, you may not get all of the calories and nutrients you need, which can worsen your symptoms and raise your risk for infections. Talk with your doctor about following an eating plan that will meet your nutritional needs. 

2) Medicines

-Bronchodilators

Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier. Depending on the severity of your COPD, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4–6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day. Most bronchodilators are taken using a device called an inhaler. This device allows the medicine to go straight to your lungs. Not all inhalers are used the same way. 

-Combination Bronchodilators Plus Inhaled Glucocorticosteroids (Steroids)

If your COPD is more severe, or if your symptoms flare up often, your doctor may prescribe a combination of medicines that includes a bronchodilator and an inhaled steroid. Steroids help reduce airway inflammation.  In general, using inhaled steroids alone is not a preferred treatment. 

3) Vaccines

-Flu Shots

The flu (influenza) can cause serious problems for people who have COPD. Flu shots can reduce your risk of getting the flu.

-Pneumococcal Vaccine

This vaccine lowers your risk for pneumococcal pneumonia and its complications. People who have COPD are at higher risk for pneumonia than people who don't have COPD. 

4) Pulmonary Rehabilitation

Pulmonary rehabilitation is a broad program that helps improve the well-being of people who have ongoing breathing problems. Rehab may include an exercise program, disease management training, and nutritional and psychological counseling. The program's goal is to help you stay active and carry out your daily activities.

5) Oxygen Therapy

If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, you're given oxygen through nasal prongs or a mask. You may need extra oxygen all the time or only at certain times. For some people who have severe COPD, using extra oxygen for most of the day can help them:

• Do tasks or activities, while having fewer symptoms
• Protect their hearts and other organs from damage
• Sleep more during the night and improve alertness during the day
• Live longer

6) Surgery

Surgery may benefit some people who have COPD. Surgery usually is a last resort for people who have severe symptoms that have not improved from taking medicines.

Surgeries for people who have COPD that's mainly related to emphysema include bullectomy (bul-EK-toe-me) and lung volume reduction surgery (LVRS). A lung transplant might be an option for people who have very severe COPD.

-Bullectomy

When the walls of the air sacs are destroyed, larger air spaces called bullae (BUL-e) form. These air spaces can become so large that they interfere with breathing. In a bullectomy, doctors remove one or more very large bullae from the lungs.

-Lung Volume Reduction Surgery

In LVRS, surgeons remove damaged tissue from the lungs. This helps the lungs work better. In carefully selected patients, LVRS can improve breathing and quality of life.

-Lung Transplant

During a lung transplant, your damaged lung is removed and replaced with a healthy lung from a deceased donor. A lung transplant can improve your lung function and quality of life. However, lung transplants have many risks, such as infections. The surgery can cause death if the body rejects the transplanted lung.

Learning Objective:  Analyze the treatment guidelines of your disease from current resources. Identify key article that will be part of your blog in this area. What are the current treatment recommendations during various stages of your disease? Describe the treatment progression. Which side effects are most important? Which side effects are most common? When does the treatment need to be stopped because of side effects?

Learning Activity 1. Find treatment information on websites, textbooks and journals. If possible create a chart with the two most frequently used treatment guidelines and compare them for their information. 2. Find information related to side effects on websites, textbooks and journals. If possible create a chart with the five most frequent side effects and what to do about them. 3. Post references that explain most comprehensively the treatments of the disease on your blog.

Key Articles: 
National Heart Lung and Blood Institute 

American Lung Association.

Anderson B, Conner Anderson B, Conner K, Dunn C, et al. Institute for Clinical Systems Improvement. Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). https://www.icsi.org/_asset/yw83gh/COPD.pdf. Accessed May 5, 2014.

Balkissoon R, Lommatzsch S, Carolan B, Make B. Chronic obstructive pulmonary disease: a concise review. Med Clin N Am. 2011;95:1125-1141