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The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included. As such, ask your doctor if you need to take any special precautions. Use each of these medicines as recommended by your doctor. Make sure to follow the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Numerous medicines may be prescribed to treat COPD. These medicines may be taken by mouth or inhaled into the lungs. Some work by opening the airways. Others are designed to reduce inflammation, or eliminate infections. The list below is a sample of some of these medicines. Doctors may often choose drugs closely related to those listed. They may also choose combinations of drugs.

Short-acting bronchodilators include:

  • Albuterol (Proventil)
  • Terbutaline (Brethine)
  • Theophylline (Theobid)

Long-acting bronchodilators include:

  • Salmeterol (Serevent)
  • Formoterol (Foradil)
  • Arformoterol (Brovana)
  • Ipratropium bromide (Atrovent)
  • Tiotropium (Spiriva)
  • Theophylline (Theobid)

These drugs work by relaxing the smooth muscles of the respiratory tract. This allows the bronchial passages to open, which makes breathing easier. Depending on the medicine that is prescribed, these drugs may be taken by mouth, inhaled, injected, or given through an IV .

Possible side effects include:

  • Fast heartbeat
  • Nervousness, trembling
  • Headache
  • Heartburn or nausea
  • Insomnia
  • Constipation with tiotropium
  • Dry mouth with tiotropium
  • Sore throat with tiotropium

Common names include:

  • Beclomethasone (Beclovent)
  • Triamcinolone (Azmacort)
  • Budesonide (Pulmicort)
  • Flunisolide (AeroBid)
  • Fluticasone (Flovent)

Corticosteroids reduce inflammation in the airway walls. They are frequently used if airway obstruction cannot be kept under control with bronchodilators. Corticosteroids are often provided in an inhaled form. This allows them to work directly on inflamed lung tissue. Few serious side effects are associated with their use if inhaled.

Possible side effects from inhalation therapy include:

  • Headache
  • Dry throat or mouth
  • Hoarseness
  • Mouth or throat fungus ( thrush)

Systemic corticosteroids, taken by mouth or by IV, may also be used to treat COPD exacerbations. However, long-term use in COPD is not usually recommended.

Supplemental oxygen may be given in the hospital or as home oxygen therapy. There are three common forms of oxygen delivery. A nasal cannula is a two-pronged device inserted in the nostrils. It is connected to a tube carrying the oxygen. The tube can rest on the ears, or be attached to the frame of eyeglasses. People who need a high flow of oxygen generally use a mask. Some people who use a nasal cannula during the day prefer a mask at night. Masks are also useful for when their noses are irritated or clogged by a cold. Transtracheal oxygen therapy requires the insertion of a small flexible tube in the trachea or windpipe. The transtracheal catheter is held in place by a necklace.

Oxygen therapy raises low blood oxygen levels. This enhances your ability to tolerate exercise, and improves mental function. It also improves heart function and helps to prevent some of the heart complications of COPD. You may require oxygen only during waking hours, or you may need it at all times throughout the day. Make sure that you understand how many hours a day you should be using oxygen. It is important to follow the prescription closely.

If you are using supplemental oxygen, it is extremely important that you do not smoke cigarettes. You should also avoid all other sources of fire or flame, such as candles or gas stoves. These could produce an explosive reaction. You should also avoid drinking alcohol or sedatives, since these can slow your breathing rate.

While on supplemental oxygen therapy, contact your doctor if:

  • You develop a headache, blue lips, confusion, or agitation
  • Your breathing becomes very shallow
  • You are still very tired following slight exertion
  • Tetracycline or Doxycycline (Achromycin, Sumycin)
  • Ampicillin or Amoxicillin (Polycillin, Amoxil)
  • Trimethoprim-sulfamethoxazole (Bactrim, Septra)
  • Clarithromycin (Biaxin)
  • Azithromycin (Zithromax)
  • Erythromycin (Emycin, EES)
  • Cephalosporins
  • Quinolone ( Ciprofloxacin , Levofloxacin)

Antibiotics are used to treat bacterial infections that could further limit breathing. They are frequently prescribed at the first sign of a respiratory infection, such as increased production of green or yellow sputum or fever. Usually, they are taken for 3-7 days. Some are taken with food or on an empty stomach. It is usually best to avoid alcohol while taking antibiotics.

Some of the more likely side effects include:

  • Diarrhea
  • Headache
  • Stomach ache
  • Sore mouth or tongue
  • Vaginal itching due to growth of fungus or yeast
  • Increased sensitivity to sunlight with tetracycline
  • Rash

Talk to your doctor before using any over-the-counter medicines if you have COPD.

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Know what side effects could occur. Discuss them with your doctor.
  • Talk to your doctor before you stop taking the medication.
  • Plan ahead for refills if you need them.
  • Do not share your medication with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.

Contact your doctor if you:

  • Have serious side effects, such as increased shortness of breath or signs of an allergic reaction, including swelling of the face, lips, or eyelids
  • Have prolonged nausea, vomiting, or diarrhea
  • Develop white spots in your mouth or vaginal itching (possible yeast infection)
  • Have severe or prolonged muscle cramps or heart palpitations
References:

About COPD. American Lung Association website. Available at: http://www.lung.org/lung-disease/copd/about-copd. Accessed March 29, 2013.

COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated March 5, 2013. Accessed March 29, 2013.

Explore COPD. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/copd. Updated June 8, 2012. Accessed March 29, 2013.

Inhaled corticosteroids for COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated January 29, 2013. Accessed March 29, 2013.

What you can do about a lung disease called COPD. Global Initiative for Chronic Obstructive Lung Disease website. Available at: http://www.goldcopd.org/uploads/users/files/GOLD_Patient_RevJan10.pdf. Accessed March 29, 2013.

9/14/2006 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Appleton S, Poole P, Smith B, et al. Long-acting beta2-agonists for poorly reversible chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006;3.

7/6/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Yang IA, Fong KM, Sim EHA, Black PN, Lasserson TJ. Inhaled corticosteroids for stable chronic obstructive pulmonary disease [review]. Cochrane Database of Systematic Reviews. 2007;2:CD002991.

6/4/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: El Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM. Abstract Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax. 2008;63:415-422. Epub 2008 Jan 30. Review.

Last reviewed June 2013 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


 
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