Theophylline tablets
If you are not getting adequate relief from the symptoms of obstructive pulmonary disease, COPD, by using bronchodilator inhalers, your doctor may prescribe theophylline tablets. Theophylline causes the muscles of your airways to relax and open up.
Theophylline increases the strength of your diaphragm (the large muscle at the base of the chest that is used when breathing) and speeds up how quickly you clear mucus and phlegm from your lungs. This helps you to breathe more easily.
Before taking theophylline tablets, you will need to give a blood sample. This is to measure the amount of theophylline in your blood and help your doctor to prescribe the appropriate dose of theophylline tablet. Also, measuring the amount of theophylline in your blood will reduce the likelihood of side effects.
Due to the risk of potential side effects, such as increasing your heart rate and headaches, other medicines, such as a bronchodilator inhaler, are usually tried first, before theophylline.
Mucolytic tablets or capsules
Mucolytics, such as carbocisteine, make the mucus and phlegm in your throat thinner and easier to cough up. They are particularly beneficial for people with moderate and severe COPD, who have frequent or bad flare-ups.
Antibiotics and steroid tablets
If you have a chest infection, your doctor may prescribe a short course of antibiotics and steroids tablets for obstructive pulmonary disease.
Steroid tablets may also be prescribed as a short course for one or two weeks if you have a bad flare-up. They work best if they’re taken as the flare-up starts, so your doctor may give you a course to keep at home.
Nebulisers
A nebuliser can be used for severe cases of COPD. A nebuliser is a machine that administers medicine through a mouthpiece or a face mask. The medicine is in a liquid form, and is converted into a fine mist. This enables a large dose of medicine to be taken in one go.
You can usually choose whether you would prefer to use the nebuliser with a mouthpiece or a facemask. Your doctor will advise you how to use the nebuliser correctly.
Before starting this treatment, your doctor or COPD specialist will test to make sure that the nebuliser is suitable for you.
Long-term oxygen therapy
In extreme cases of COPD, when the oxygen in your blood is low, you may need to take oxygen from an electronically operated ‘oxygen concentrator’ through nasal tubes or through a mask.
This must be taken for at least 15 hours a day. The tubes from the machine are long so you will be able to move around your home while you are connected.
Portable oxygen tanks are also available and liquid oxygen may be available in the future.
Do not smoke when you are using an oxygen concentrator. The increased level of oxygen that is produced is highly flammable, and a lit cigarette could trigger a fire or an explosion.
Pulmonary rehabilitation programmes
Pulmonary rehabilitation programmes are a form of therapy to improve your respiratory symptoms and sleep, and can increase your exercise capacity, mobility and self-confidence.
The programme involves:
- education,
- exercise,
- psychological support,
- advice on stopping smoking, and
- nutritional assessment.
Pulmonary rehabilitation takes place in a group and the course usually lasts for about six weeks. During the course, you will learn more about your COPD and how to control your symptoms. Pulmonary rehabilitation can greatly improve your quality of life.
Hospitalisation
In rare cases, hospitalisation may be necessary if you are having an exacerbation of COPD (a particularly severe attack).
In hospital, you are likely to receive oxygen, antibiotics (if necessary) and a nebuliser to help ease your symptoms. If your COPD is very severe, a stay in hospital is nearly always more effective than resting at home because your condition can be constantly monitored by medical professionals.
Lung transplantation
Lung transplantation is rare in cases of COPD and it is usually only suggested if your life expectancy is less than two years.
Although lung transplantations are usually very successful, you will need to take anti-rejection medication for the rest of your life. The medication will help your body to accept the new organ, but it can have unpleasant side effects, such as headaches and high blood pressure (hypertension).
Lung volume reduction surgery (LVRS)
Lung volume reduction surgery (LVRS) is when the damaged parts of your lung are removed during surgery. This can improve your symptoms, but may put you at increased risk of catching pneumonia or developing an air leak where the lung is re-sealed.
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