What should I know about COPD exacerbations?

Dr. Jeanne Morrison, PhD
Family Practitioner

Chronic obstructive pulmonary disease (COPD) is the chronic blockage of airways in the lungs, causing difficulty breathing and shortness of breath. In advanced COPD, a sudden worsening of symptoms can cause an exacerbation, also known as a flare-up. An exacerbation can lead to acute respiratory disease, which can result in death. You can manage your risk for an exacerbation by avoiding air pollutants and smoke, and maintaining a healthy lifestyle with regular exercise. If you become sick, see your doctor immediately for proper treatment.

From time to time, people with chronic obstructive pulmonary disease (COPD) might get exacerbations, also called flare ups, when they feel more breathless and more unwell than usual. If the flare ups are severe, they may need to stay in a hospital for a short while.

Dr. Teresa Wyze. Seright, PhD, RN
Critical Care Nursing Specialist

A COPD exacerbation is a progressive worsening of symptoms to the point the patient's ability to respond to poor oxygenation is exhausted.

Combination inhalers, containing both corticosteroids and broncho dilators (beta adrenergic agonists) are often prescribed to individuals with COPD. These inhalers are meant to be used on a scheduled basis and are not "rescue" inhalers for increased airway 'tightness'. The bronchodilator relaxes and smooths the airways, while the corticosteroid controls inflammation.

When an individual with COPD experiences an exacerbation to the point they must be hospitalized, they are typically given broncho dilators as a first-line treatment to relax the airways. They may also be treated with intravenous and oral corticosteroids to immediately control airway inflammation.

It is important for patients and caregivers to understand that while corticosteroids play an important part in controlling inflammation in severe distress, they are not meant to be used in the inhaled form to "rescue" the patient from breathlessness or severe dyspnea. The best drug for this situation is the inhaled bronchodilator (an example would be Proventil).

Another important point for patients and caregivers is that if the individual with COPD begins using their bronchodilator (rescue) inhaler more frequently than usual, they should contact their provider, as this may indicate an underlying problem that needs attention before it becomes an exacerbation.

Joane Goodroe
Nursing Specialist

Nurses and respiratory therapists will support you when your chronic obstructive pulmonary disease (COPD) gets worse. Some patients will be treated on an inpatient basis and others may receive home health care. Your doctor will determine which care you need.

Niamh van Meines
Nursing Specialist

Usually when you have a COPD exacerbation you have symptoms that affect your respiratory system such as shortness of breath and coughing. If these symptoms are severe and you are having difficulty catching your breath, the nurse will call the doctor, decide with you whether you would like to go to the hospital & stay with you until you feel better.

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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.