Written by SMH Clinical Pharmacist Ashleigh Beachy, PharmD
Did you know that 16 million people in the U.S. are living with COPD (chronic obstructive pulmonary disease)? And that nearly 1 million COPD sufferers have to be hospitalized each year for treatment?
COPD causes coughing, wheezing, extra mucus and shortness of breath, and suffers may struggle to take deep breaths. Genetics, lifestyle habits, like smoking tobacco or vaping, and environmental factors like air pollution, are often to blame for COPD or the respiratory infections that can lead to disease development.
The good news is that this common lung disease can be controlled by medication, and taking simple steps can help people with COPD stay healthy and out of the hospital.
Tips to Stay Healthy & Breathe Easier
In it’s more important than ever that we commit to staying healthy. For COPD sufferers, there are some easy steps that can be taken to support your health and help prevent a hospital visit.
- Wash your hands often.
- Avoid touching your face.
- Get a flu shot early.
- Get a pneumonia vaccination.
- See your primary care doctor for a checkup every year, and specialists as recommended. Take a list of all your medications to each appointment.
Take all medicine ordered by your doctor. Some inhalers should be used daily, even if you aren’t having trouble breathing. Set an alarm to remind you to take your medication every day.
Even if you use your medications every day and try to avoid getting sick, it is possible COPD can get worse. People living with COPD can have a flare, or exacerbation, of their symptoms.
Call your doctor if you have frequent coughing, low energy for everyday activities, more or thicker mucus, difficulty sleeping well or need to use your inhaler(s) more often.
Medications Used in COPD Treatment
Inhalers allow medicine to get where it needs to be: the lungs. There are three main types of inhaler medications used in COPD treatment; some daily-use inhalers have a combination of all three medications.
Anticholinergics — These keep your airways from getting too small, and are available in short-acting and long-acting formulas. Tiotropium, ipratropium and umeclidinium are examples of prescribed anticholinergics; side effects of these include dry mouth, dry eye, constipation and stomach upset.
Beta2 agonists — Available in short- and long-acting formulas, beta2 agonists open up your lungs to make breathing easier, allowing more air in and out. Albuterol, levalbuterol and salmeterol are all beta2 agonists. Some side effects of these include increased heart rate, shaking hands, low potassium and restlessness.
Corticosteroids — Corticosteroids reduce swelling in your airways. Commonly prescribed corticosteroids include mometasone, budesonide and fluticasone. Available only as long-acting treatments, these may cause side effects like white spots in the mouth (rinse mouth with water after every use) and problems talking.
Maintenance medications are taken every day, even if you don’t feel short of breath. Rescue medications are taken only when you need them. For example, long-acting beta2 agonists are taken every day, even if you feel well. But, short-acting beta2 agonists are used when you feel short of breath, wheezing or are about to exercise.
Types of Inhalers & How to Use Them
There are many different kinds of inhalers, and just as it’s important to find the right medication for your COPD, it’s important to get the right inhaler.
To feel your best and get the most out of your medicine, learn how to use your inhaler correctly.
Dry Powder Inhalers — With dry powder inhalers (DPIs), the user needs to breathe in the fine powder fast and strong, in order to get the full amount of medication. After inhaling the powder, the user should hold their breath for about 10 seconds, or as long as they can comfortably. Common DPIs include Ellipta, Diskus, Handihaler and Twisthaler.
Tips for Using DPIs
- Ellipta — When the number on the front has gone down by one, the inhaler is ready to use. Diskus — Push the lever on the side to ready the inhaler for use.
- Handihaler — Insert 1 capsule into the inhaler and push the green button; inhale twice for a full dose. Do not swallow the capsule.
- Twisthaler — When the counter number has gone down by one, the inhaler is ready to use.
Inhalers, aka ‘Puffers’ — Using standard inhalers, alos known as “puffers,” requires some coordination. Shake the unit well for at least 10 seconds, and hold the inhaler in an “L” shape. After exhaling, make a seal with your mouth around the inhaler opening; press down on the top of the inhaler while breathing in slowly and deeply.
Soft Mist Inhalers — Easier to use soft mist inhalers don’t require coordinating a pump while breathing in. Users simply twist the inhaler, open the cap and push the button while inhaling the mist slowly and deeply.
If you have questions about medication, talk with your pharmacist or doctor. And follow the “Stay Healthy Tips” above to support your overall health and keep your COPD in check.
Ashleigh Beachy, PharmD, is a clinical pharmacist at Sarasota Memorial Hospital. She completed her education at Lake Erie College of Osteopathic Medicine - Bradenton in 2019, followed by a PGY-1 pharmacy residency at SMH. Her responsibilities include precepting pharmacy students and providing care for both pediatric and adult patients.