How do medications treat chronic obstructive pulmonary disease (COPD)?

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Dr. Darria Gillespie, MD
Emergency Medicine Specialist

Bronchodilators relax the muscles that control your airways to open them up for better air flow. There are four types of bronchodilators used to treat COPD: short-acting beta-agonists, long-acting beta-agonists (LABAs), anticholinergic drugs and theophylline. These medications are usually inhaled. This is done with a small hand-held canister, also called an inhaler or a nebulizer machine. Some forms of these drugs can be taken as a pill or intravenous (IV) infusion.

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Medications for treating chronic obstructive pulmonary disease (COPD) work in three key ways:

  1. Beta-2 agonists and anticholinergics signal the musculature surrounding the small airways to open.
  2. Steroids decrease inflammation and swelling in the small airways.
  3. Smoking cessation medications help smokers to quit.

Several types of medications are used to relieve symptoms and treat the complications of chronic obstructive pulmonary disease (COPD). Inhaled bronchodilators increase airflow by relaxing the muscles around your airways. Depending on the severity of your COPD, you may need to use bronchodilators before activities, on a daily basis or a combination of both. In advanced COPD, inhaled corticosteroids can reduce airway inflammation and make breathing easier. Finally, antibiotics may be prescribed to fight respiratory infections that can aggravate your COPD.

Stacy Wiegman, PharmD
Pharmacy Specialist

There is no cure for COPD, and the condition worsens over time, but treatments can slow the progression of the disease and ease symptoms. Some treatments for COPD include:

  1. Advair treats COPD through the action of two medications. COPD, which includes conditions such as chronic bronchitis and emphysema, cannot be cured, but symptoms such as difficulty breathing can be relieved. The two medications in Advair, fluticasone and salmeterol, are an inhaled steroid and a bronchodilator. The bronchodilator is a muscle relaxant that allows passages in the lungs to open up, making breathing easier. Steroids complement this by reducing swelling and inflammation in the lungs.
  2. Daliresp (roflumilast) prevents or relieves symptoms of severe COPD by blocking the action of phosphodiesterase type 4 (PDE4), an enzyme that causes swelling in the lungs.
    In people with COPD, limited airflow in the lungs leads to trouble breathing, chronic cough and spitting up of mucus. 
  3. Salbutamol, also named albuterol, relaxes the airway muscles that have a tendency to contract in people with COPD. It works on the nervous system by activating the beta receptors whose purpose is to help send signals to the smooth muscles, such as the muscles along the bronchial tubes in the lungs. Salbutamol signals these muscles to relax.
  4. Serevent (salmeterol) is a bronchodilator that is used to prevent and treat COPD. Types of COPD that Serevent treats include chronic bronchitis and emphysema. It can also help to eliminate breathing difficulties during exercise. It works by loosening and opening the airways in the lungs, making breathing easier. Serevent is a type of medication called a long-acting beta agonist (LABAs).
  5. Spiriva (tiotropium) treats COPD by reducing the bronchospasm and breathing difficulties associated with the disease. Spiriva works to open airways that are constricted due to COPD.
  6. Tiotropium (Spiriva HandiHaler) is a bronchodilator—a type of medicine that helps relax air passages. In COPD, your air passages can be swollen, making it difficult to breathe properly. Symptoms of COPD may include cough, wheezing, shortness of breath and chest tightness.
Linda Martinez
Cardiac Rehabilitation Specialist

Yes, bronchodilators are commonly used to treat people with COPD in a critical care setting. They are commonly given via a nebulizer treatement where the patient inhales the medication through an oxygen mask. Metered dose inhalers are another common way bronchodilators can be given. In some instances, the bronchodilator can also be given via an intravenous (IV) line.

Columbia Admin
Administration Specialist

Steroids dilate the bronchial tubes and decrease the swelling of the lining and inflammation of the cells. Up to 20 percent of COPD patients, mostly those with asthma or asthmatic bronchitis, benefit from steroid therapy; however steroid treatment has little to offer emphysema patients. The potential side effects of systemic steroids include osteoporosis, diabetes, weight gain, cataracts and hypertension. These side effects are always of major concern.

Continue Learning about Chronic Obstructive Pulmonary Disease Treatment

Chronic Obstructive Pulmonary Disease Treatment

Chronic Obstructive Pulmonary Disease Treatment

Chronic obstructive pulmonary disease (COPD) is a type of long-term lung disease where airflow in the lungs is restricted, making breathing difficult. COPD usually results after years of smoking; the best way to keep it from getti...

ng worse is to quit. Treatment options include medications, inhalers, pulmonary rehabilitation, oxygen therapy and lifestyle changes like exercise and quitting smoking.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.