LIVING WELL WITH COPD Oral Corticosteroids Oral corticosteroids (eg; prednisone) reduce inflammation and swelling in the airways. They make it easier for air to flow in the lungs. However, they have several adverse effects. Their use is often limited for short courses (5-7 days) to treat acute exacerbations (flare-ups). Theophylline In some cases, people with COPD don’t respond well to the most commonly prescribed inhaled medications. Theophylline relaxes the muscles in the airway. It is often combined with other medications, particularly bronchodilators. Theophylline is a non selective phosphodiesterase (PDE) inhibitor. It has been used to treat COPD and asthma for over 20 years. It is often considered a fourth line therapy for COPD due to its side effects. It requires patients to have blood draws to follow drug levels. Theophylline It’s important to take all your medications correctly to get the best benefits and improve your breathing. Read the package inserts for all your medications. Follow the instructions exactly to take each one. If you have any questions about your medications, ask your doctor or pharmacist. 24 use may be associated with many adverse effects. It may interact with other medications you are taking. Your doctor will need to check this. He or she may order blood levels to make sure your dose is not too high. Roflumilast The phosphodiesterase (PDE) inhibitor roflumilast (Daliresp) inhibits inflammation in the airway. It’s indicated for people with frequent episodes of chronic bronchitis. It has been shown to reduce COPD flare-ups in patients who are prone to flare-ups. Roflumilast use may be accompanied by diarrhea and nausea. Your health- care provider may need to adjust your dose or stop the medication. Expectorants Expectorants (mucolytic medicines) are sometimes used to treat the increased or thicker mucus that can occur with COPD. This mucus clogs airways, making it harder to breathe. These medicines may help keep mucus thin and more easily cleared from the airways. The expectorant most commonly used for COPD is guaifenesin. Most studies, however, show that drinking fluids is as good as taking mucolytics. Antibiotics People with COPD are more prone to: • • • Colds Flus Pneumonia To treat a bacterial infection and reduce symptoms, your doctor may prescribe a course of antibiotics. Azithromycin may be prescribed to reduce the risk of flare-ups. You may be asked to take this three times a week.