Which is the best medicine for chronic obstructive pulmonary disease?

Chronic Obstructive Pulmonary Disease (COPD) is projected to be the world’s third most common cause of death and the fifth most common cause of disability worldwide by next year, 2020. COPD is a disease of the narrowing airways (chronic bronchitis) or permanent damage to the distant air sacs (emphysema).

COPD is highly associated with risk factors such as smoking, pollution, poorly ventilated kitchen/workplace and genetic factor. Patients developing COPD are strongly advised to stop smoking to prevent further deterioration of their breathing capacity. There is no single medicine that works to reverse or completely treat the COPD once it started. Here are the drug classes and examples of medicines used to treat COPD.

  • Beta-Adrenoceptor Agonist

This is a common and a must class of drug for not only COPD but also for asthma. Beta-adrenoceptor agonist or beta-agonist for short works by stimulating the tissue of the airways to dilate thus reducing the breathlessness symptoms of COPD. Beta-agonist has two forms which are the short-acting for quick symptoms relief and the long-acting for long-term prevention. Examples of this class of drug are like Salbutamol (short-acting) and Salmeterol (long-acting) inhalers.

  • Antimuscarinics

Antimuscarinics work by inhibits the acetylcholine at the cholinergic receptor of the bronchial (small airways) smooth muscles. This results in dilation of the airways hence reducing the shortness of breath symptom. A prolong dilation is believed to be exerted by antimuscarinic agents but similar efficacy is seen with the beta-agonist. Examples of antimuscarinic drugs are ipratropium bromide and tiotropium bromide. Antimuscarinics also have short-acting and long-acting preparation serving a similar function as the beta-agonist drugs.

  • Roflumilast

Roflumilast is a phosphodiesterase type 4 inhibitor which serves to reduce inflammation in the lung airways. Since COPD is a chronic inflammatory condition, medications that are targeting inflammatory cells in the lungs are much of help in managing COPD patients in the long run.

  • Corticosteroids

The first two classes of drugs mentioned above function as a bronchodilator in which they treat the symptoms by temporarily reversing the narrow airways to become dilated. Corticosteroids or steroids for short and roflumilast act on the different principle that is to reduce the inflammation from progressing on hence preventing the disease from becoming worse. Steroids have either inhalation or by tablets form. The former is usually act as mild preventer while the steroids tablet is reserve for more advanced COPD as the side effects of the systemic steroids are difficult to manage.

  • Antimucolytic agents

Antimucolytics serve to relieve the symptom of chronic sputum or phlegm faced by COPD patients. Example of antimucolytics is carbocysteine.

  • Antibiotics

Antibiotics play a major role in managing COPD since most patients will have an infective exacerbation or “flare-up” of their COPD, especially during winter or flu season. COPD patients are more susceptible to lungs infection (pneumonia) due to their impaired breathing, impaired mucus excretion and impaired immune system.

  • Oxygen

In a very severe or late-stage COPD patient, oxygen support is needed whether at home or at a hospital. Strict rules and criteria are used to determine if oxygen therapy is suitable and safe for the patient or not. This must be prescribed only a specialist in COPD.

COPD is a debilitating disease and needs specialist input for better management. People with COPD which needs to buy their medication regularly can now buy their medication by DoctorOnCall and have it delivered for them.