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You are in: Home > Chest Information > Chest Conditions > Chronic Obstructive Pulmonary Disease > Treatment of COPD

Medical Treatment of COPD

• Aims of treatment
• Inhalers
• Spacers
• Nebulisers
• Oxygen therapy
• Other drugs / vaccinations
• Acute exacerbations and hospital admissions
• Palliative care

Aims of treatment

COPD is a chronic condition which means that it cannot be cured.

COPD usually worsens over time. However, there are treatments available which can ease symptoms (e.g. breathlessness), reduce your risk of exacerbations and improve your quality of life.

• There is also a lot that you can do to help yourself and prevent further damage to your airways.

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Inhalers

Inhalers are often used to treat COPD. Inhalers allow drugs to be delivered directly to the lungs. There are 3 main types of inhaler drugs:

• Relievers
• Long–acting relievers
• Preventers

It is very important that you use your preventer and long–acting reliever inhalers regularly.

• Inhalers are very effective but only if used correctly and taken regularly.

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Spacers

If you have difficulty with your inhaler technique or the physical handling of an inhaler you may find a spacer helpful.

Nebulisers

The drugs used in the inhalers are usually also available in solution form to be used with a nebuliser.

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Oxygen therapy

For some people with COPD, breathing air with a higher concentration of oxygen can help to reduce some of the symptoms caused by a lack of oxygen.

Receiving additional oxygen is called oxygen therapy and must be prescribed by a doctor.

You must be assessed to find out if you will benefit from oxygen therapy and how much you require.

Some people may only need a small additional amount of oxygen, and could be harmed by getting too much oxygen.

Some people may need long-term oxygen therapy: if you have COPD you may have to use oxygen for at least 15 hours / day to gain benefit. You can use it overnight and at quiet times during the day to make up the 15 hours.

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Other drugs / vaccinations

• Oral bronchodilators: usually only given to people who have not had effective relief from inhalers or who cannot use inhalers. They help to widen your airways by relaxing the muscles around them.
• Oral steroids: these may be prescribed to help you get over a flare–up of your symptoms, if they are not improving with your usual treatment. You should never stop taking your steroids suddenly without consulting your doctor.
  Sometimes it is necessary to be on steroids for longer periods of time. If this is the case it is advisable to carry a treatment card on you.
• Antibiotics: these drugs fight bacterial infections. It is especially important to start treatment for an infection as soon as possible if you have COPD.
• Flu vaccine: everyone with COPD should have this yearly immunisation, available every year from late September.
• Pneumococcal vaccine: you usually only need to have this once.

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Acute exacerbations and hospital admissions

If your condition suddenly deteriorates you may need to be admitted to hospital for emergency treatment. This is often referred to as an acute exacerbation.

On admission to hospital you are likely to need:

• Oxygen therapy
• Nebulised drugs
• Antibiotics
• Blood tests: including an arterial blood sample. This test shows how much oxygen your lungs are getting into your body and how well your body is getting rid of carbon dioxide (waste product that your body produces when oxygen is used).

Normally your lungs are able to get rid of carbon dioxide by taking deeper and quicker breaths. If you have COPD and develop a severe chest infection you may not be able to do this, and carbon dioxide can build up in your blood. This can make you very unwell.

Depending on the results of your arterial blood gas there are two treatment options that may be tried:

• Fixed oxygen: the oxygen mask that you have on may be changed to one that gives you a fixed dose of oxygen. This ensures that you aren't being given too much or too little oxygen.
• BiPaP (bilevel positive airway pressure): also called non–invasive ventilation. It involves wearing a larger mask which forms a seal around your mouth and nose. The mask is attached to a machine which, as you breathe in, helps your lungs to expand. It does this by pushing air and oxygen in and, when you breathe out, it helps your lungs to empty. It does feel quite strange at first, and can be quite scary, but it can make a difference relatively quickly. BiPAP is generally only used for a short spell during your hospital admission but sometimes it can be used at home.

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Palliative care

COPD can progress for a variety of reasons. For example, getting older, repeated chest infections and continuing to smoke can all speed up the disease process.

In time, if your symptoms become more difficult to control, your doctor or nurse may talk to you about palliative care services. Specialist palliative care nurses and doctors are highly trained professionals who can offer support, to you and your family, and management of your symptoms at every stage of your disease.

As COPD can not be cured the emphasis of palliative care is to find ways to control your symptoms and provide you with all the help and support you may need.

Initially you will have a palliative care assessment which involves a full assessment of your symptoms and how they are impacting on your day–to–day life, what treatment you are on at the moment and discussions around any other treatment that may be useful.

Your weight and dietary intake will be considered and you can see a dietician if necessary. Your mobility will be assessed and you may be referred to other services such as physiotherapy, occupational therapist or district nurses. A welfare review will also take place to ensure you are receiving all the benefits that you are entitled to.

You will have plenty of opportunity to talk about your disease, how you feel you are coping with it and also to explore what may happen in the future and talk about your particular wishes or fears.

For more information about all aspects of palliative care see NHS inform's Palliative Care Zone.

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