Shortness of breath is the main symptom of COPD that typically limits physical activities and can be disabling. Relief of shortness of breath is one the key goals or treating COPD. In June 2018, the FDA approved the Zephyr Endobronchial Valve System. It is an implantable bronchial valve used to reduce over inflation of the lungs due to severe emphysema. The device consists of a one-way silicone duckbill valve that only allows air to exit from trapped areas. In the LIBERATE study, those with severe hyperinflated emphysema who received placement of Zephyr valves experienced improvements in breathlessness, activity, and psychosocial aspects for one year compared with standard of care.

In November 2018, the FDA approved Primatene Mist for the treatment of mild intermittent asthma. As it is the only over-the-counter inhaler approved by the FDA, some individuals with COPD may consider using it. The active ingredient is epinephrine which plays an important role in the fight-or-flight response; it stimulates the heart to beat faster and harder. Misuse and overuse of Primatene have been well documented and has been associated with people dying. Also, patients may self-medicate with Primatene Mist, thereby delaying effective care. I advise against use of Primatene Mist because of safety concerns. Albuterol is a safer alternative, but requires a prescription.