Chronic Obstructive Pulmonary Disease (COPD) (cont.)
Medical Author:
George Schiffman, MD, FCCP
George Schiffman, MD, FCCPDr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine. Medical Editor:
William C. Shiel Jr., MD, FACP, FACR
William C. Shiel Jr., MD, FACP, FACRDr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology. In this Article
 CorticosteroidsWhen airway inflammation (which causes swelling) contributes to airflow obstruction, antiinflammatory medications (more specifically, corticosteroids) may be beneficial. Examples of corticosteroids include prednisone and prednisolone (Pediapred Oral Liquid, Medrol). Twenty to thirty percent of patients with COPD show improvement in lung function when given corticosteroids by mouth. Unfortunately, high doses of oral corticosteroids over prolonged periods can have serious side effects including:
Therefore, many doctors use oral corticosteroids as the treatment of last resort. When oral corticosteroids are used, they are prescribed at the lowest possible doses for the shortest period of time to minimize side effects. When it is necessary to use long term oral steroids, medications are often prescribed to help reduce the development of the above side effects. Corticosteroids also can be inhaled. Inhaled corticosteroids have many fewer side effects than long term oral corticosteroids. Examples of inhaled corticosteroids include:
Inhaled corticosteroids have been useful in treating patients with asthma, but in patients with COPD, it is not clear whether inhaled corticosteroids have the same benefit as oral corticosteroids. Nevertheless, doctors are less concerned about using inhaled corticosteroids because of their safety. The side effects of inhaled corticosteroids include hoarseness, loss of voice, and oral yeast infections. To decrease the deposition of medications on the throat and increase the amount reaching the airways, spacers can be helpful. Spacers are tube-like chambers attached to the outlet of the MDI canister. Spacer devices can hold the released medications long enough for patients to inhale them slowly and deeply into the lungs. A spacing device placed between the mouth and the MDI can improve medication delivery and reduce the side effects on the mouth and throat.Rinsing out the mouth after use of a steroid inhaler also can decrease these side effects. It is less clear whether spacing devices help with deposition or side effects of other inhaled medications. Advair, a powered inhaler device, contains both salmeterol (a long acting beta-agonist) and fluticasone (an inhaled steroid). This medication has shown to be effective in COPD patients with chronic bronchitis. Its major side effects include the possible development of thrush (oral candidiasis) and hoarseness. Another combination medication available in an MID device is budesonide and formoterol (Symbicort). Reviewed by William C. Shiel Jr., MD, FACP, FACR on 5/13/2013 Patient CommentsViewers share their comments
Chronic Obstructive Pulmonary Disease - Causes
Question: What was the cause of your COPD?
Chronic Obstructive Pulmonary Disease - Experience
Question: Were you, a friend, or relative diagnosed with COPD? Please share your experience.
Chronic Obstructive Pulmonary Disease - Symptoms
Question: The symptoms of chronic obstructive pulmonary disease can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Chronic Obstructive Pulmonary Disease - Treatments
Question: What treatment has been effective for your COPD?
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