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Chronic Obstructive Pulmonary Disease / COPD

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Treatment

Patients are strongly advised to quit smoking. COPD may be treated with medications and sometimes surgery.


Treatment of COPD includes:

Quit smoking:  Since smoking is the major risk factor in the development and worsening of COPD, the patient is strongly advised to give up smoking.  Patients should be offered medications like bupropion and nicotine replacement therapy along with counseling to help them quit smoking.

Medications that may help to relieve symptoms and improve the patient’s condition are:

Drugs that widen the air passages such as tiotropium, salbutamol and salmeterol.  These may be prescribed via inhalation so that they may be more effective and the side effects may be less.

Inhaled corticosteroids may help to reduce the number of attacks in COPD patients.

Theophylline also helps to improve lung function by relaxing the bronchi, improving contraction of diaphragm and stimulating the respiratory center.

N-acetyl cysteine helps by breaking down thick mucus plugs and acting as an antioxidant.

Oxygen:   Oxygen reduces the risk of death in patients suffering from severe COPD.

Attacks of COPD may be treated with drugs that dilate the bronchi (administered through a device called the nebulizer), antibiotics, corticosteroids and oxygen.  Very severe cases may need to be put on a ventilator.

Intravenous alpha-1 antitrypsin augmentation therapy:   Alpha-1 antitrypsin augmentation therapy may be administered to patients lacking alpha-1 antitrypsin with COPD.  Patients should receive hepatitis B vaccine before treatment.

Flu and pneumococcal vaccine:  The patient is advised flu (influenza) and pneumococcal vaccine to prevent infection.

Surgery:  Some patients with emphysema may benefit from a surgery where parts of the lungs are removed.  Patients with very severe COPD may need lung transplantation.

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