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
 COPD medicationsThere are a variety of medications prescribed to treat COPD. BronchodilatorsTreating airway obstruction in COPD with bronchodilators is similar but not identical to treating bronchospasm in asthma. Bronchodilators are medications that relax the muscles surrounding the small airways thereby opening the airways. Bronchodilators can be inhaled, taken orally or administered intravenously. Inhaled bronchodilators are popular because they go directly to the airways where they work. As compared with bronchodilators given orally, less medication reaches the rest of the body, and, therefore, there are fewer side effects. Metered dose inhalers (MDIs) are used to deliver bronchodilators. An MDI is a pressurized canister containing a medication that is released when the canister is compressed. A standard amount of medication is released with each compression of the MDI. To maximize the delivery of the medications to the airways, the patient has to learn to coordinate inhalation with each compression. Incorrect use of the MDI can lead to deposition of much of the medication on the tongue and the back of the throat instead of on the airways. Chlorofluorocarbons (CFCs) have been removed from all MDI inhalers because of the environmental effects on the ozone layer. These have been replaced by a new propellant, hydrofluoroalkane (HFA). Patients may notice that the jet they feel in the back of their throat is less intense when compared with the CFC inhaler. They should be instructed that they are still receiving the same amount of medication though it may feel different than their older inhaler. Another very important point that patients must be aware of is that "floating" these new inhalers does not help in determining the amount of medication left in the MDI. In the past, the CFC devices could be floated in a bowl of water. With more medicine in the inhaler, the canister would sink and gradually float as it emptied. This is not the case with the HFA inhalers. The number of inhalations must be counted to determine if medication is still left in the inhaler. Shaking the inhaler is not an effective method of determining how much medication is left. Often propellant (HFA) will continue to come out of the inhaler even after the medication is used up. At the present only one albuterol inhaler comes with a counter device and this is Ventolin-HFA. 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: Please share your experience with COPD.
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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