HEALTHNET

What is chronic obstructive pulmonary disease (Part 2)?

There is no cure for COPD. Any damage to the lungs caused by COPD is irreversible.

(Posted on 6 September 2007)

Treatment of COPD

There is no cure for COPD. Any damage to the lungs caused by COPD is irreversible. However, there are ways to relieve the symptoms of COPD. The most important intervention in COPD is smoking cessation. Avoiding dusty and smoky environments will also help. Patients may consider having a flu immunization and getting a vaccination against pneumococcal pneumonia to reduce the chances of being vulnerable to complications after such infections.

Common drugs used for the treatment of COPD include:

(1) Bronchodilators

Bronchodilators can relax and dilate the bronchi. Commonly used bronchodilators include β- receptor agonist, anticholinergics and theophylline. The common side effects of β- receptor agonist (such as Salbutamol and Salmeterol) are tremor, tachycardia and palpitations. The side effects of anticholinergics (such as Ipratropium and Tiotropium) include bad taste in the mouth, skin flushes, blurred vision, dry mouth, dysuria and glaucoma. The side effects of theophylline include nausea, vomiting, muscle cramps, gastrointestinal setup, arrhythmia, agitation, tremor or nervousness. β- receptor stimulants and anticholinergics are normally inhaled as aerosol sprays. If used correctly, the drugs should be able to enter the lungs directly to take effect so that the systemic side effects will be reduced.

(2) Steroids

Although steroids fail to slow down the progression of the disease, steroid medication - either by inhalation or itaken orally - has been found to improve the condition of some patients who suffer with severe COPD. Steroids can also be used in acute exacerbations of COPD.

(3) Mucolytics

Patients suffering from chronic obstructive pulmonary disease, and chronic bronchitis in particular, often have excessive amount of purulent sputum. Mucolytics can thin out the phlegm, which can then be clogged up the airways more easily. The use of mucolytics can reduce the likelihood of bacterial infection being caused by the accumulation of sputum in the lungs.

(4) Antibiotics

Antibiotics may be effective in treating acute exacerbations of COPD caused by bacterial infection.

In addition, severe COPD patients with hypoxaemia may need long-term oxygen therapy to improve symptoms of shortness of breath and enhance the exercise capability of the patients. Patients may also join the pulmonary rehabilitation program, which aims to improve patients' exercise tolerance, reduce symptoms and the likelihood of complications, increase patients' general knowledge of the disease , and thereby improving their quality of life. The rehabilitation program includes breathing training and respiratory muscle conditioning to prevent accumulation of sputum. There may also be strength building exercises for the upper limbs to help patients maintain exercise capability.

Source: Hong Kong and Drug Education Resources Centre, The Society of Hospital Pharmacists of Hong Kong