Kevin Huang, BSc Pharm Student
Do you find yourself coughing, wheezing, and gasping for air? Are you someone who smokes regularly? Do you wish you didn’t have to deal with problems of shortness of breath? If you answer yes to these questions, there is a chance you are dealing with chronic obstructive pulmonary disorder (COPD). COPD is a pulmonary inflammatory disorder commonly caused by smoking and second-hand pollution. When exposed to these agents, the airways become inflamed and release mucus. This results in narrowing of the airways and symptoms of breathlessness, wheezing, and coughing. Early awareness of this condition is imperative as COPD is preventable. If managed early, COPD can be partially reversed. Thus, people who suspect they have COPD should contact their healthcare team to help improve their quality of life as soon as possible.
When managing COPD, it is important to understand these two main goals:
- To minimize the severity of your symptoms.
- To slow the progression of your condition (not alter its course).
The one most important thing you can do to help your body is to stop smoking. Smoke from cigarettes irritates your lung’s airways, thus causing previously mentioned inflammation and mucus release. This can make it more difficult for you to breath. While quitting smoking can be extremely difficult to do, it is one of the best things you can do to for your body. When you decided to quit smoking, don’t hesitate to reach out to your team for medical assistance.
Outside from quitting smoking, there are other things we can do to help. Often times, they are lifestyle modification and changes to the current environment. Gradual reintroduction of physical activity based on your physical ability will help improve your endurance and quality of life. Meanwhile, minimizing your exposure to second-hand smoke and air pollution will help reduce the symptoms of COPD. Implementing these three actions can make a tangible difference in your management of this condition and improve your quality of life.
Sometimes, lifestyle modifications aren’t enough. When breathlessness and wheezing are not controlled, many physicians may start you on medical therapies. The choice of treatment depends on your severity of COPD. Furthermore, proper inhaler technique is vital in maximizing the effectiveness of your treatment. Today, we will break down the common choice of medications which you may be working with.
- Short-Acting Bronchodilator (Rescue Inhaler – Ex. Salbutamol): Short-acting beta-agonists (SABA) are commonly prescribed inhalers used to managed acute episodes of shortness of breath. These agents are used on an “as needed basis” since SABA only provides short-term relief to your symptoms. However, it is important to know that frequent use (>2-3 times/week) indicates that your condition is not controlled and may benefit from long-acting bronchodilators (LABD).
- Long-Acting Bronchodilator (Control Therapy – Ex. Spiriva, Onbrez Breezhaler, Seebri Breezhaler): LABAs are long-term medications which help manage your symptoms over longer periods of time. Many of these agents revolve around relaxing the airways to allow oxygen to flow through the passageway. At times, physicians may add on inhaled corticosteroids (ICS) to help manage inflammation within the lungs. Regardless of what therapy you may start on, it’s imperative that you use the medication daily. Otherwise, the treatment will not help manage your symptoms.
When to call for help
Lifestyle modification and medications are the two most important things you can do to help manage your COPD. Unfortunately, there may be a time where you find yourself dealing with the symptoms, even if you are doing everything right. This is what we call an acute exacerbation. These events are a medical emergencies which require immediate medical intervention. Keep an eye out for the following red flags. If you are experiencing any of event below, immediately contact 911:
- My medications have not helped alleviate my symptoms and they have been ongoing for more than 2 days.
- I am experiencing severe shortness of breath, nervousness, confusion, dizziness, and/or chest pain.
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