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Back Aims of treatment There is currently no cure for COPD. There are two main goals of treatment. The first is to help control your symptoms and improve exercise tolerance, so you can carry on with your daily activities and improve your overall health status. The second goal is to reduce the risk of complications, by slowing down the disease progression, and by preventing and treating COPD flare-ups. Your healthcare provider will work with you to review your symptoms and to adjust your treatment plan accordingly. If you want to keep an overview of how well your symptoms are under control, you may want to keep a symptom diary at home. Even though this symptom diary hasn’t been formally studied in research, it may still help you remember how you felt at different times and make it easier to discuss your COPD with your doctor. Examples of these documents can be downloaded here for personal use (permission to distribute for personal use only!). Quitting smoking If you haven’t already, then the most essential step in your treatment plan for COPD will be to quit smoking. Although the damage to your lungs that has already been done can’t be reversed, quitting smoking will prevent further loss of lung function. No matter how long you have had COPD, quitting smoking can help slow progression of the disease. Your symptoms, like breathlessness, coughing, and phlegm will improve and you will be less likely to experience COPD flare-ups. Find out more about quitting smoking in our Lifestyle and Prevention module. Inhalers Most COPD medicines are taken using an inhaler. These small, hand-held devices deliver the medicine directly into the lungs, so it doesn’t need to travel through the bloodstream to reach its target. Some medicines are taken using a nebuliser, which is a machine that turns liquid medicine into a fine mist that you can breathe in through a mask or a mouthpiece. Nebulizers are mainly used in hospitals during severe flare-ups to deliver higher doses of medicine. In some cases, they can also be used at home for people with more advanced COPD, especially if inhalers are no longer effective or too difficult to use. Bronchodilators Bronchodilators are medicines to help open up your airways. They are considered the cornerstone of treatment for patients with COPD. Bronchodilators are categorized based on the duration of effect. Short-acting bronchodilators work within a few minutes to relax the muscles in your airways and relieve your symptoms. They are prescribed for use ‘as needed’ when symptoms flare-up. There are two types of short-acting bronchodilators: Short-acting beta agonists (SABA, for example: salbutamol/albuterol): they quickly relieve symptoms and can be used as needed. They are often prescribed as ‘reliever’ or ‘rescue’ inhalers. Some people may feel a bit shaky or notice a faster heartbeat after using a SABA. These side effects are usually short-lived but can feel uncomfortable. If you’re ever concerned about side effects, talk to your healthcare provider. Short-acting muscarinic antagonists (SAMA, for example: ipratropium): they are prescribed in case your symptoms are mild and infrequent, to use as needed. SAMAs are sometimes prescribed if you experience bothersome side effects of SABA use, like feeling shaky or a rapid heart rate. There are very few common side effects of SAMA use, but headaches, a sore throat or a dry mouth have been described. Correct inhaler technique and frequently taking a sip of water can help reduce the risk of side effects. If you’re ever concerned about side effects, talk to your healthcare provider. You might be prescribed a combination of SABA and SAMA, depending on the severity and frequency of your symptoms. If you experience breathlessness on a daily basis, your doctor will probably prescribe a long-acting bronchodilator. These medicines help relax and open up the muscles in your airways, making it easier to breathe. They act more slowly than short-acting bronchodilators, but their effects last much longer, usually between 12 and 24 hours. When taken regularly, they help keep your airways open and support your breathing throughout the day. There are two types of long-acting bronchodilators: Long-acting beta agonists (LABA, for example: vilanterol or olodaterol). There are very few common side effects. You might notice headaches, a faster heart rate or feeling shaky. If you’re ever concerned about side effects, talk to your healthcare provider. Long-acting muscarinic antagonists (LAMA, for example: tiotropium or umeclidinium). Side effects are uncommon, but you might notice having a dry mouth. Drink plenty of water to help ease your discomfort from a dry mouth. If you’re ever concerned about side effects, talk to your healthcare provider. Many people with COPD who experience breathlessness use a combination of two long-acting medicines: a LABA and a LAMA. The combination can be prescribed as two separate inhalers or as a single combination inhaler, which is often more convenient and more effective than multiple inhalers, but sometimes a bit more expensive. Expected side effects are those of the separate medicines. Inhaled steroids Steroids, also called corticosteroids, are medicines that help reduce inflammation. When inhaled, they act directly in the lungs to decrease swelling and irritation. Not everyone with COPD needs inhaled steroids (ICS). These inhalers are usually prescribed for people who have frequent COPD flare-ups or higher levels of a certain type of white blood cells called ‘eosinophils’. They are also recommended for people who have both COPD and asthma. Inhaled steroids only work properly when used on a regular basis, so it is important to use them as prescribed.  It is also important to know that this treatment mainly helps reduce the number of flare-ups, but it has less effect on day-to-day symptoms compared with other inhalers such as LAMA or LABA. In terms of expected side effects, it is important to know that inhaled steroids work locally in the airways, at the site of the inflammation. Hence, only a little enters the blood stream, leading to few side effects. Oral thrush (a yeast infection in the mouth) is the most common side