It’s a natural question for anyone who has been diagnosed with (or who knows someone dealing with) chronic pulmonary obstructive disease: “Is there a COPD cure?”
There may not be a COPD cure, but treatment with COPD medications and other approaches can relieve symptoms, prevent the disease from getting worse, and improve the ability to exercise. COPD medications also can prevent and treat COPD complications, and prevent and treat COPD exacerbations.
While a COPD cure doesn’t exist, there is help in the form of medications. The mainstay of the COPD medications list: drugs called bronchodilators, which open the airways. Almost every person suffering from COPD will be prescribed a short-acting bronchodilator (either a beta-agonist, an anticholinergic, or a combination of both) to use on an as-needed basis to relieve shortness of breath, coughing, wheezing, and other symptoms.
Some people will also need a long-acting bronchodilator and/or an anti-inflammatory drug. Your doctor will work with you to figure out the right COPD meds and combinations of meds to relieve your symptoms.
All About Bronchodilators
Bronchodilators expand the airways, making it easier to breathe. There are two main types of bronchodilators—beta-agonists and anticholinergics—and each is available in a short-acting and a long-acting formulation. Find out more on our COPD medications list.
- Beta-agonists activate a receptor called the beta-2 receptor on muscles surrounding the bronchial tubes. This causes the muscles to relax and the airway to dilate. Beta-agonists are available in short-acting and long-acting formulations. Short-acting beta-agonists start to work within minutes and last about four to six hours. Long-acting beta-agonists take longer to begin working (about 20 minutes), but last up to 24 hours. Most beta-agonists are taken in an inhaled form, but they are available as pills as well.
- Anticholinergics block a receptor in the lung to prevent constriction of the airways. This allows the airways to remain open. Short-acting anticholinergics start to work within 15 minutes and last for six to eight hours. Long-acting anticholinergics typically take about 20 minutes to start working, and last for 24 hours.
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For a person with mild COPD who has occasional symptoms, a short-acting bronchodilator alone may be sufficient to manage the condition. The physician may also prescribe two short-acting bronchodilators—a beta-agonist plus an anticholinergic—to use together. To simplify this regimen, some combinations of a short-acting beta-agonist plus a short-acting anticholinergic are available in one inhaler (see our COPD medications list).
As lung function deteriorates and COPD signs and symptoms worsen, additional treatments will likely be necessary. For people with moderate or severe COPD, for whom symptoms tend to occur more frequently, one or more long-acting bronchodilators will be added to the regimen. For patients with more severe disease, whose COPD prognosis is poor (for example, Stage 4 COPD—the most serious of the disease’s stages) some combination of drugs (such as two long-acting bronchodilators) will likely be used.
Anti-Inflammatory Drugs (Corticosteroids)
COPD meds may include anti-inflammatory drugs (corticosteroids) to reduce swelling in the bronchial tubes. They can be taken in tablet, liquid, injected, or inhaled form. Corticosteroids are recommended for people with moderate or severe COPD (Stage 4 COPD, for example), who do not get sufficient relief from bronchodilators, or experience frequent COPD complications called exacerbations.
Corticosteroids in pill form are generally reserved for COPD exacerbation treatment. The effects are felt within a few hours of taking the drug: Breathing will become easier, coughing and wheezing will ease, and mucus production will lessen.
Even though they have such pronounced effects, oral corticosteroids are generally used only for a short period of time (a few days to a few weeks). This is because in addition to reducing inflammation, corticosteroids have other effects on the body that can cause unwanted and sometimes severe consequences. But with inhaled versions of these COPD meds, the medication is delivered directly to the lungs—very little medication travels through the bloodstream, which means there will be few side effects.
COPD Exacerbation Guidelines
An exacerbation is a sudden flare-up of COPD symptoms beyond normal day-to-day variations. Increased breathlessness, along with wheezing, chest tightness, increased cough and sputum, a change in the color of sputum, and fever are common features of an exacerbation. Exacerbations may warrant either a short-term or long-term change in medication, and they sometimes require hospitalization.
COPD exacerbation treatment, in lieu of a COPD cure, includes three types of medicatrions: bronchodilators, corticosteroids, and antibiotics if the exacerbation is caused by a lung infection.
COPD Cure? No, But Inhalers May Help
While bronchodilators can be taken in different ways, the preferred method for delivering the drug in patients with obstructive airway disease is through inhalation, using an inhaler device. Inhalers deliver bronchodilator or corticosteroid medication as a spray, mist, or fine powder.
Three types of inhalers are available: a metered dose inhaler (MDI), a dry powder inhaler (DPI), and a nebulizer.
- Metered dose inhalers: A metered dose inhaler (MDI) is a small, pressurized canister with a mouthpiece and a metering valve that contains medication. The patient places his or her mouth over the mouthpiece, and then inhales slowly and deeply while pushing down on the top of the canister to deliver a precise dose of the COPD meds. Once the medication is delivered, the patient must hold his or her breath for about 10 seconds before exhaling.
Many people find it helpful to use a spacer device with their MDI to improve drug delivery. A spacer is a short tube that is placed between the mouthpiece of the inhaler and your mouth. The medicine enters the tube, and from there it can be inhaled more slowly and deeply. This results in more effective delivery of the medication to the lungs.
- Dry powder inhalers: A dry powder inhaler (DPI) is similar to an MDI, but it doesn’t contain a propellant. Using a DPI requires inhaling more deeply and quickly to propel the medicine out of the device and into the lungs, but overall, DPIs tend to be somewhat easier to use, as they don’t require the coordination of taking a breath while actuating the device with your hand. To use a DPI, simply place your mouth tightly over the mouthpiece and inhale quickly. A DPI inhaler should not be shaken before use (like an MDI); nor are spacers used.
- Nebulizers: Inhaled medications like bronchodilators and corticosteroids can also be delivered via a nebulizer. A nebulizer is a machine that turns a liquid form of a drug into a fine mist that is then inhaled through a mouthpiece or facemask. Nebulizers can be useful for those who have more severe lung disease, or have difficulty using MDIs or dry powder inhalers.
Originally published in February 2016 and updated.
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