COPD Treatment

Quitting smoking is the most important step you can take to treat COPD. Ask your doctor about programs and products that can help you quit.

Many hospitals have programs to help people quit smoking. Moreover, hospital staff can refer you to one of these programs. Ask family and friends for support. Also, avoid secondhand smoke. Exposure to secondhand smoke is also called passive smoking.

Other treatments for COPD include medicines, vaccines, pulmonary rehabilitation, oxygen therapy and surgery. The doctor can also give advice for the management of complications.

Usually COPD symptoms get worse slowly and over a period of time. However, they can worsen suddenly. For example, a cold, flu or a lung infection can worsen the symptoms very quickly. This can make it much more difficult for you to breathe and you may also feel chest tightness, increased coughing, changes in color or amount of sputum (phlegm) and fever.

Call your doctor right away if this happens. He or she may prescribe antibiotics to treat the infection and other medications such as bronchodilators and inhaled steroids to help you breathe better.

For some severe symptoms may require treatment at a hospital.

The goals of COPD treatment are:

 The treatment of COPD has three main objectives:

• stop the progression of the disease,
• relieve the symptoms ( especially shortness of breath or difficulty in breathing),
• and finally treating complications that may arise from the disease.

Slowing the progression of the disease:

There are four steps that can help slow the progression of chronic obstructive pulmonary disease in certain circumstances

• Quitting smoking
• Treatment with inhaled corticosteroids
• Oxygen Therapy
• Treatment with alpha-1-antitripisina.

Not Smoking:

The most effective measure to curb the progression of the disease is, without doubt, to quit smoking.

When a patient has been diagnosed with COPD this implies that there is already a chronic obstruction to the airflow and this obstruction is irreversible.

However, many patients continue to smoke in this situation. Not smoking slows the decline in lung function, even when COPD is advanced.

Furthermore, although the benefit is greater during the first year, the improvement continues in subsequent years.

Simply put any patient with COPD should seriously consider quitting to prevent the disease from progressing.

Treatment with inhaled corticosteroids:

For years, it has also been suggested that treatment with corticosteroids may slow the development of COPD, to reduce existing inflammation in the bronchial tree. It has been necessary to conduct scientific studies to demonstrate that inhaled corticosteroids may be useful in this regard, primarily in the treatment of patients with advanced COPD. One of these studies used an inhaled corticosteroid, called fluticasone (that prevents and helps decrease inflammation in the nose) which was able to significantly improve the overall health and reduced the number of exacerbations in patients suffering from severe forms of the disease.

Oxygen therapy:

Oxygen therapy provides supplemental oxygen to patients with lung diseases or other conditions affecting lung function and the reduction of the amount of oxygen that is transferred into the blood.

In advanced stages of the disease when there is chronic respiratory failure it has been shown that oxygen therapy increases the survival of patients, slowing the progression of the disease. It also improves neurological functions, reduces hospital stays and increases exercise tolerance. These are obtained through multiple mechanisms where a decrease in pulmonary vascular resistance, reduced pulmonary arterial hypertension and the number of circulating erythrocytes in the blood are obtained.

Treatment with alpha-1-antitripisina:

The deficiency of the enzyme alpha-1-antitrypsin, can also be a cause of COPD. Patients with this deficit have an increased amount of a substance called elastase, responsible for the destruction of the parenchyma or lung tissue. Alpha-1 antitrypsin is a protein that protects our lungs and the deficiency is an inherited disorder that can cause lung disease in adults and liver disease in adults and children.The enzyme replacement therapy with alpha-1-antitrypsin achieved in some cases a stabilization of lung function values, although for COPD the benefits have not yet been clearly demonstrated.

How To Relieve Patients Symptoms:

There are two measures that aim to improve patients' symptoms, particularly dyspnea.

• On the one hand there is the pharmacological treatment
• and secondly respiratory rehabilitation.

To evaluate the effectiveness of the different available treatments and patient´s response to each of these, three methods have been used: Spirometry, the relief of symptoms as reported by patients themselves and, recently, quality of life questionnaires.

 Pharmacological Treatment:

Bronchodilators
Bronchodilator medications are most effective in reducing symptoms in patients with COPD and their use is recommended by inhalation. These drugs act at different levels not only producing bronchodilation or widening of the bronchial lumen, but some may help remove secretions or improve even the contractility of the diaphragm. Sympathomimetic bronchodilators are considered or beta-2-agonists, anticholinergics and theophylline.

 Other Drug Treatments for COPD

Sympathomimetics (betamimetics)
They are very useful in controlling symptoms in patients with COPD. It is advisable to use pressurized aerosols inhaled through presentations or dry powder. There are two types of sympathomimetics:
  - The fast-acting, such as salbutamol and terbutaline.
  - The long-acting salmeterol and formoterol.
 
The long-acting are dosed every 12 hours to maintain a constant degree of bronchodilation, while fast-action on are used on demand when the patient notices symptoms. It is therefore essential that you always carry one (in your pocket or purse) in case of need. Its effect is almost immediate, lasting for several hours. Although there are oral preparations, it is not advisable to use them as their efficiency is lower and they increase the risk of side effects. The main side effects of these drugs include irritability, insomnia, nervousness and tachycardia.
 

Anticholinergics
Bronchodilator medications are also good, and though they are somewhat slower than that of sympathomimetics, they do retain its effect for longer periods. These drugs, compared with sympathomimetic bronchodilators show an equivalent effect, although some researchers have demonstrated additional benefits for anticholinergics. On the basis of this they are sometimes used in the first therapeutic step of COPD.

Since sympathomimetics and anticholinergics are drugs of different families and have different mechanisms of action, their administration can have complementary effects and additives.

Theophylline
They were widely used in patients with COPD in recent years. However, their use has been reduced as there action mechanism is not clearly understood, they can cause significant side effects, can result in difficult clinical management, requiring accurate monitoring of theophylline levels in the blood and it interferes with many medications commonly used. Therefore before being used careful risk-benefit consideration should be taken into account, evaluating their use when the use of other bronchodilators do not sufficiently control symptoms.

Respiratory Rehabilitation:

Pulmonary or respiratory rehabilitation is a program supervised by a doctor and helps to improve the health and welfare of people with lung problems.
The program can include exercise, nutrition and psychological counseling as well as training in ilness control.
The rehabilitation team may be composed of physicians, nurses, physiotherapists, respiratory therapists, exercise specialists and nutritionists. These health professionals work together with you to design a program that fits your needs.
Respiratory rehabilitation seeks to retrain the patient's breathing patterns and exercise their respiratory muscles. Trained therapists also teach maneuvers to keep the airways clear of secretions and guide the patient in chest movement exercises

This treatment prevents, improves and stabilizes (if any) alterations in the respiratory system. Among other applications, chest physiotherapy "increases self-confidence, prevents infections of the bronchi and lungs, improves respiratory muscle strength, reduces the number of hospital admissions and respiratory function optimized."

Pulmonary rehabilitation programs for patients with COPD are focused on the whole person, achieving a remarkable improvement in their quality of life.