Thoracic Diseases COPD, Medical Treatments

Smoking Cessation

The primary recommendation for preventing and treating COPD is to stop smoking. Smoking alone is responsible for 82% of COPD.

Bronchodilators

Bronchodilators relax the muscles of the bronchus, allowing air to get in and out easier. These medications are available in pill or liquid form (taken orally), or as an aerosol spray (inhaled).

Steroids

Steroids dilate the bronchial tubes and decrease the swelling of the lining and inflammation of the cells. Up to 20% of COPD patients, mostly those with asthma or asthmatic bronchitis, benefit from steroid therapy, however steroid treatment has little to offer emphysema patients. The potential side effects of systemic steroids include: osteoporosis, diabetes, weight gain, cataracts, and hypertension. These side effects are always of major concern.

Anti-Infective Agents

Antibiotics are frequently used during bronchitic exacerbations to fight bacterial infections. Flu and pneumonia vaccinations are recommended for all patients with COPD. The influenza shot is administered yearly while the pneumonia shot is administered every five years.

Oxygen Therapy

Oxygen therapy has proven beneficial in improving the quality and length of life in selected emphysema patients.

Nutrition

Proper nutrition is critical for COPD patients. Weight loss, which is common in patients with advanced emphysema, can be caused by inadequate food intake in individuals too short of breath to eat. However, most weight loss in COPD patients is due to the increased metabolic demand of respiratory muscles that are overworked because of emphysema damage.

Emphysema sufferers who lose weight are sicker and face increased mortality risks. Long-term benefits have not been demonstrated from the use of oral or IV supplements to improve nutritional health. Researchers have recently begun investigating using anabolic steroid to treat these patients.

Pulmonary Rehabilitation

Pulmonary rehabilitation has clear benefits for patients with COPD. Exercise increases endurance, improves shortness of breath, increases maximal oxygen consumption, improves quality of life, and decreases the overall length of stay in the hospital. However, these improvements tend to be limited and eventually plateau. Additionally, rehabilitation does not confer improvement in lung function or overall oxygen requirements, and its survival benefits are unclear.

NewYork-Presbyterian/Columbia offers a comprehensive, program for individuals with chronic lung disease, including exercise training, education, nutrition counseling, and a monthly support group. To learn more, click here.