Pulmonary Medication

There are different medications used for the treatment of pulmonary disease symptoms, this article will explain what they do and help you understand why you’re taking them.

Bronchodilators 

These are your most common medication, also known as a reliever.  The purpose of these drugs are toprevent and relieve symptoms of breathlessness.  They work by relaxing the smooth muscles in the airway, which allows the airway to open up, therefore increasing air flow, and improve lung emptying.  You may have heard that there are two types, short acting, and long acting.  The short acting are used when you are breathless and need relief, they work quick to reduce the bronchospasm and reduce airway narrowing.  The effects can last up to 4 hours.  The long acting is the second type, they help to relieve tension of the smooth muscles and open the airways over a longer period.  Usually they last up to 12 hours and are taken in the morning and evening.  Common names include Salbutamol, Terbutaline, Salmeterol and Formoterol.  Brand names include Ventolin, Bricanyl, Oxis and Serevent.  

Anticholinergics

These drugs have two functions, they help to reduce bronchospasm and open the airway like the relievers, but they also reduce mucus production.  There are short acting and long acting.  The short acting takes 30-60 minutes to start working and last for 3-6 hours, the long acting takes 15 minutes to start working and last up to 24 hours. They help to increase exercise capacity and quality by reducing the patient’s breathlessness.  Common names include Ipratropium bromide and Tiotropium.  Brand names include Atrovent and Spiriva.  

Methylxanthines

A more uncommon drug for the treatment of COPD, were used for bronchodilation of the airway, but due to their narrow therapy usage and side effect, the prescription of these drugs has gone down.  Common names include Theophylline and Aminophylline.

Inhaled Corticosteroids and Oral Steroids 

These drugs are mainly used for the reduction of inflammation in patients with asthma, COPD, and pulmonary fibrosis, helping to widen the airway.  They have also been shown to reduce exacerbations in COPD patients, which is a key part of preventing disease progression.  These drugs must be used regularly if prescribed, so that they build up in the system. There is evidence that these drugs help to improve symptoms and help to improve scores on lung functions test.  Common names include Budesonide, Fluticasone, and Prednisolone. 

Combination Therapy

This is where two drugs are prescribed to treat severe asthma and COPD and reduce their exacerbations.  The drugs are a combination of bronchodilators and steroids.  Combination therapy has been shown to be more effective than monotherapy at relieving symptoms and improving lung function.  Common names include Seretide and Symbicort.  

Antibiotics

Antibiotics are important for the treatment of bacterial infections.  Those with COPD are more prone to developing chest infections which can lead to exacerbations, such as severe breathlessness.  A mucus sample is required before antibiotics are prescribed.  Sometimes longer courses are required and should always be completed.  Common antibiotics prescribed to COPD patients include Amoxicillin and Doxycycline.  

 

Vaccines 

Vaccines help to prevent flu and other pneumococcal infections; these infections can cause severe complications for those with COPD.  Vaccines can help to reduce the likelihood of these complications.  It is important for pulmonary patients to discuss vaccines with their GP.

 

Mucolytic Therapy

This therapy helps to reduce the viscosity of mucus; this has been shown to reduce exacerbations in some individuals.  If there is no improvement they are discontinued after 4 weeks.  Common names include Carbocisteine and Mecysteine Hydrochloride.  Brand names include Mucodyne and Visclair. 

Cough Suppressants

This is used for patients with a dry, irritable cough.  They are not often prescribed to patients with COPD as they often have a productive cough; therefore, the cough is an important part of mucus clearance.  Most over the counter cough remedies will provide no long-term relief for patients with COPD but can help to sooth a sore throat.  Your GP should address the trigger of the cough and choose a more suitable course of action.  If you have a new cough lasting 2 or more weeks you should contact your GP.

Ryan Hodgkinson