Living with COPD is difficult -- it can keep you from the simplest tasks, such as dressing, washing, or doing light housework. What can you do? In this Health Alert, Peter Terry, M.D., Professor of Medicine in the Division of Pulmonary and Critical Care Medicine at Johns Hopkins discusses COPD treatment options.
Chronic obstructive pulmonary disease (COPD), which causes an irreversible decline in lung function, is a common and serious condition. And not surprisingly, COPD is associated with other conditions, such as malnutrition, fatigue, weight loss, and depression. COPD is not curable, but there are ways to feel better and slow the progression of your disease.
Treating COPD with medication -- Beta2-agonist drugs (albuterol, levalbuterol, metaproterenol, pirbuterol, salmeterol, formoterol), anticholinergics (ipratropium, tiotropium), and inhaled corticosteroids make breathing easier. “Taking both an anticholinergic and a beta2-agonist to treat COPD is common,” says Peter Terry, M.D. “Advair, which combines the beta2-agonist salmeterol with an inhaled steroid in one medication, is popular.”
Oral rather than inhaled corticosteroids are another option for COPD, but one that is usually reserved for acute episodes; long-term use increases the risk of conditions such as osteoporosis, diabetes, cataracts, and high blood pressure. “However,” Dr. Terry adds, “some patients in the end stages of severe COPD may benefit from oral steroids in the last six months or so of life.”
Oxygen therapy for COPD -- For COPD patients who can’t get enough oxygen into their blood breathing on their own, oxygen therapy is necessary. It can increase energy, aid sleep, and improve mood. Some COPD patients need oxygen therapy only during exercise. If you need oxygen while sitting or during non-strenuous activities (resting oxygen), it’s probably best to keep the oxygen on all the time. If 24-hour use is not an option, people who use oxygen 15 hours a day while they’re awake do better than people who use it only while asleep. If mobility is a concern, ambulatory “liquid” oxygen is available in relatively light-weight, portable canisters.
Surgery for COPD-- Advanced COPD symptoms may warrant surgery. Lung volume reduction surgery removes diseased tissue and gives the lungs room to expand. This procedure seems to help prolong the lives of some people with emphysema that affects the upper lobes of the lung. In rare cases, a lung transplant may be an option; however, donor organs are very scarce and the operation carries the risk of rejection.
