Chronic obstructive pulmonary disease (COPD) treatment and medications have two main goals. The medication should first and foremost ease the symptoms and secondly, it should prevent exacerbations. The effect of the symptom management is evaluated at every appointment, and the medication treatment is initiated and ended depending on the effect it is having on the symptoms of the patient.
To those who often suffer from exacerbations, COPD medications are given to prevent exacerbations. This treatment is to be compared with other preventive treatments, for example treatment of high blood pressure or high levels of blood lipids, and the effect can therefore not be evaluated on every appointment. This makes the COPD treatment a long-term treatment that will go on for many years.
There are two types of medications that are used for the treatment of COPD, bronchodilators and exacerbation preventing medicines. Some bronchodilating medicines also prevent exacerbations. Of the bronchodilators, the anticholinergic medicines are chosen first but also long-acting medicines and beta stimulating medicines can be used for long-term treatment. In order to prevent exacerbations, inhaled corticosteroid is given, in combination with long-acting beta-stimulators. It is of utmost importance that the patient feels confident when using the inhaler, and that he or she is able to use it correctly each time. Follow-ups on the inhalation technique should be done regularly.
Severe COPD sometimes leads to chronic respiratory failure, which should be treated with oxygen. Oxygen treatment should preferably be given 24 hours a day, and at least for 16 hours a day. It is, in other words, a chronic treatment that implies the patient carrying oxygen with him or her in all situations. The oxygen is administered through a nasal cannula, which is connected via a tube to the oxygen supply.
In case of COPD it is important to also consider the existence of other diseases. Many people who suffer from COPD also have cardiac insufficiency, which may contribute to the symptoms, especially to shortness of breath. It is not uncommon for people suffering from COPD to also have osteoporosis and bone fragility. Since infections are big problems when it comes to COPD, flu and pneumonia vaccinations are important. Exacerbations of COPD are treated acutely with inhalation of bronchodilating medication, and also often with corticosteroid tablets and antibiotics. When suffering from severe exacerbations and acute respiratory failure, the patient is brought to hospital for medication treatment and respiratory support.
UK/GEN/15/0058d Date of preparation: December 2015