Preventing COPD Flare-ups or Exacerbations
In the April 2015 issue of the journal CHEST (volume 147; pages 883-893), Criner and co-authors summarize available treatments that can help to reduce the chances of a COPD flare-up, also called an exacebation.
The authors divided the types of treatment into three categories. These recommendations are based on studies for preventing a flare-up (exacerbation), but these treatments may also improve shortness of breath and quality of life.
Non-pharmacologic and vaccinations
Gerald Criner, M.D., Chair and Professor, Thoracic Medicine and Surgery at Temple University
Inhaled medications (both beta-agonist and muscarinic antagonists are types of bronchodilators)
- flu vaccine
- stop smoking (counseling and treatments)
- pulmonary rehabilitation if the flare-up was within the past 4 weeks
- case management with direct access to a health care specialist at least monthly
- education about flare-ups with a written action plan and case management
- long-acting beta-agonist
- long-acting muscarinic antagonist
- short-acting beta-agonist plus a short-acting muscarinic antagonist
- inhaled corticosteroid and long-acting beta-agonist combination
- long-acting beta-agonist and long-acting muscarinic antagonist
If you have recently experienced one or more COPD flare-ups, you may wish to ask your doctor about these treatments to help reduce the chances of having another flare-up. For the inhaled medications, the different generic types are listed with the understanding that there are many specific brand names.
- long-term macrolide antibiotic (dose and duration of treatment are unknown)
- roflumilast (for those with chronic bronchitis form of COPD and a history of at least one flare-up in the previous year)