Treatment of COPD


In the early stages of COPD, doctors will likely recommend exercise or physical therapy – the more vigorous the better, since this improves lung function. They will also recommend a high-protein, low salt diet with plenty of fluids to thin the heavy mucus secretions associated with COPD. In addition, they may suggest losing weight if necessary, avoiding all forms of active and passive smoke sources (primarily tobacco), and excessive dust, air pollution, or exposure to certain volatile organic compound (VOC) odors like bleach and spray paint, which can exacerbate symptoms of Chronic obstructive pulmonary disease.

COPD Medications

Typical COPD medications include:

• Emergency inhalers, or short-acting bronchodilators like albuterol or ipratropium
• Long-Acting bronchodilators like Tiotropium or Salmetrerol, via a nebulizer (mist) machine
• Tablets like roflumilast (Daliresp), which is a phosphodiesterase-4 (PDE4) inhibitor
• Corticosteriods, like Prednisone, in pill form
• Methylxanthines for severe cases of COPD where other resources have failed

Oxygen, the Standard of Care

Chronic Obstructive Pulmonary Disease is staged, much like cancer, from 1 to 4. Stage 4 is defined as having an exhalation volume below 30 percent of normal, which makes oxygen the standard of care. Initially delivered in pulses, at a rate of 2 liters per minute, from either machines or tanks, oxygen is essential to some stage 3 and all stage 4 COPD victims. In stage 4, patients receive oxygen 24/7, the liters delivered per minute continuously rather than in pulses, and the rate of delivery raised slowly from the standard 2 to 4 or more. This helps patients maintain the functional integrity of not only lungs but brain and heart – all of which require oxygen to survive and function.

Having Chronic Obstructive Pulmonary Disease can lead to lack of oxygen and a condition called cerebral hypoxia. This occurs when the brain is getting enough blood but not enough oxygen. In this condition, brain cells can start dying in five minutes. Untreated hypoxia may also lead to:

• Depression or other significant mood disorders
• high blood pressure (hypertension)
• increased heart rate
• heart failure
• pulmonary hypertension
• acute respiratory failure, typical of stage 4 COPD
• secondary polycythemia (abnormal increase in number of red blood cells)

COPD Medications and Surgical Therapies

If a COPD patient develops some of the side effects of later stage, doctors may also prescribe blood pressure medications and other heart medications. They may also prescribe steroids, in spite of their adverse side effects, to relieve airway inflammation. COPD treatments of last resort involve surgeries. These include bullectomies, bronchoscopic LVRS (lung volume reduction surgery), and lung transplants.

Alternative COPD Treatments

Because the above treatments come with so many hazards, some patients elect “natural” remedies involving diet, herbs, and supplements. In the nutrition arena, omega-3 fatty acids decrease inflammation and vitamin E is said to improve COPD lung function. Both however can cause bleeding problems, particularly when taking a prescription blood thinner like Warfarin, so consulting a doctor is mandatory.

Because antioxidants can help reduce the oxidative stress inherent in COPD, dieticians highly recommend red grapes, green tea, turmeric, broccoli, tomatoes, sweet potatoes, and kale. Mind/body therapies like Yoga, meditation, and breathing exercises may also be useful in curbing COPD symptoms and improving COPD quality of life.

Reference: Kevin M. Chan, Fernando J. Martinez, and Andrew C. Chang “Nonmedical Therapy for Chronic Obstructive Pulmonary Disease“, Proceedings of the American Thoracic Society, Vol. 6, No. 1 (2009), pp. 137-145.