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Chronic obstructive pulmonary disease - What treatments work for COPD?

BMJ Group Medical Reference

Chronic obstructive pulmonary disease (COPD) is a lung disease that's usually caused by smoking.

If you have COPD and smoke, the best thing you can do is stop smoking. This can help slow down how quickly the disease gets worse.

There aren't any cures for COPD, but doctors and therapists can do a lot to help you breathe more easily and to make you feel better.

Key messages about treating COPD

  • Stopping smoking is the best thing you can do for COPD.

  • Treatments to help you stop smoking include counselling, nicotine gum, or a drug called bupropion.

  • Taking regular exercise can make you fitter and improve your symptoms.

  • Medicines that you breathe in (inhalers or nebuliser treatments) may help your lungs work better and should help you feel less breathless.

  • Taking two drugs that you breathe in, one to open up the airways and one to reduce inflammation, may also help to prevent attacks of COPD (when your symptoms suddenly get worse).

  • Taking a drug to break up the mucus in your lungs, so it's easier to cough up, may reduce your risk of having an attack.

  • If your COPD is very bad, having extra oxygen to breathe at home can help you live longer.

What you can expect from the NHS

If you've got COPD, you'll be cared for mainly by your GP. But you may also get help from a team of specialists, such as a specialist lung nurses, physiotherapists, occupational therapists, and dietitians. If your COPD gets very bad, you may need to be treated in hospital.

The National Institute for Health and Clinical Excellence (NICE), the government body that advises doctors about which treatments should be available on the NHS, has published guidance for doctors on how to treat COPD.[16] This can give you some idea about what treatment you can expect.

  • If you smoke, your doctor will probably encourage you to stop and offer you some help. For example, you might be offered nicotine replacement therapy or the drug bupropion (Zyban). And you might be encouraged to attend a local group for people who are trying to give up smoking.

  • The first treatment you'll get to help your COPD symptoms is an inhaler that helps open up the airways in your lungs (called a bronchodilator). This will be a short-acting inhaler, which means it works for about 4 hours. You might get one that contains a drug called a beta-2 agonist (salbutamol or terbutaline) or an anticholinergic drug (tiotropium or ipratropium).

  • Your doctor will consider various inhaled drugs, and combinations of drugs, to help you to breath better. If your symptoms are not improving, it's important to tell your doctor.

  • If your COPD is so bad that it stops you doing the things you used to do, such as going to the shops or meeting up with friends, then you should be offered a programme of treatment called pulmonary rehabilitation. This involves learning about COPD and how it's treated, advice about diet and exercise, and support to help you cope with your condition.

  • If you cough up phlegm, your doctor might try you on tablets to help clear it up. These might be carbocisteine or mecysteine.

  • You might get oxygen to breathe at home. You usually have to do this for 15 hours a day for it to help, though if you use it for longer, it might help more.

  • You may be referred to a specialist to see if surgery could help you. This usually involves removing some of your lungs or a lung transplant.

  • It is common to get depressed when you have COPD. Your doctor may ask you questions to see how you are feeling. If you are depressed, you should be offered treatment for it.

  • You should get a vaccination every year against flu and pneumococcal disease. These conditions can make your COPD worse.

If you have a bad COPD attack (when your symptoms get suddenly much worse), you may get some other treatments.

  • Your doctor might put up your dose of bronchodilator. Or you may breathe this in through a mask using a machine called a nebuliser rather than an inhaler.

  • You might get a course of antibiotics.

  • If you are very breathless, your doctor might prescribe a course of steroid tablets.

  • Depending on how these treatments work, your doctor will decide whether you can stay at home or if you need to be treated in hospital.

  • In hospital you might get oxygen to breathe in through a mask, or you may be put on a ventilator to help you breathe.

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Last Updated: March 13, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
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