Your doctor is the best resource for learning which COPD medication you should take and how it should be administered. But there may be signs that indicate you should check that you’re on the right medicine and using it the right way. Types of COPD medications include the following: Bronchodilators These are used to relax the muscles around the airways to help keep them open, making it easier to breathe. This substance can be delivered through an inhaler or a nebulizer. Bronchodilators can be short acting, with quick relief from symptoms that wears off within a few hours, or long acting, which takes longer to work but provides relief over the course of several hours. Steroids These anti-inflammatory medications reduce swelling and slow mucus production in the airways to improve breathing. Although usually delivered via an inhaler, they can be swallowed as a pill when the symptoms are very severe. Typically, they are prescribed as a combination medication with bronchodilators. There are potential side effects that come with steroids, including weight gain and increased risk for diabetes. Combination medications These medications combine steroids and bronchodilators into one inhaler or nebulizer solution. Phosphodiesterase-4 inhibitors These medications decrease airway inflammation and relax the airways to improve breathing. Antibiotics These are prescribed in the case of respiratory infection, which can make COPD symptoms worse. Your doctor may prescribe a combination of the above medicines, depending on the severity of your COPD and your symptoms. RELATED: COPD Treatment and Prevention Here are some signs that you may want to talk to your doctor about your treatment regimen and the potential need for changes.
1. Your Symptoms Get Worse
The biggest indicator that your COPD is getting worse would be increased shortness of breath and less activity, less ability to move or do things like climb stairs or walk up a slight incline, says Robert A. Wise, MD, the director of research in pulmonary and critical care medicine at Johns Hopkins Medicine in Baltimore. “A worsening cough, wheezing or chest tightening and a change in phlegm, either in consistency, volume or color are other signs that your condition is getting worse,” says Dr. Wise. Symptoms can also get worse if you’re not taking your medication correctly, which is relatively common, says Wise. “Most people with COPD should periodically ask their physician or healthcare provider to make sure that they’re using their inhaler properly,” he says, adding that there are a number of how-to videos online. There are probably a dozen different types of inhalers, and it’s quite common for people to use their inhaler in a less-than-optimal fashion, according to Wise. “Very often, if someone is worsening, it’s not a matter of changing their medication, but rather ensuring that they are using their inhaler properly,” he says.
2. Edema or Weight Gain
Worsening edema or swelling of the ankles may indicate chronically low oxygen, says Wise. This can be a result of what is called cor pulmonale, or right-sided heart failure. According to a 10-year survey of people with COPD who were discharged from the hospital, more than 1 out of 4 were diagnosed with heart failure. The excess fluid that a person retains with edema can cause 5, 10, or even 15 pounds of weight gain, according to Wise.
3. You Wake Up With a Throbbing Headache
“When your oxygen level gets low, people often have difficulty sleeping,” says Wise. “That’s usually a sign of a substantially severe exacerbation.” That condition is called hypoxia, and the buildup of excess carbon dioxide in the blood can happen while you sleep and cause a morning headache. Morning headaches may also be a sign of sleep apnea, a condition that happens more often in people with COPD.
4. A Change in Your Vital Signs
“Sometimes if a person is taking the wrong dose of their COPD medication it can affect [their] blood pressure, pulse rate, or even their electrolytes,” says Wise. “A person can get low potassium sometimes from certain types of inhalers.” It’s important to continue to have your vital signs and your electrolytes checked routinely to make sure your body is processing the medication appropriately.
5. You No Longer Get the Same Benefit from the Medication
In general, even if you’ve been on your COPD medication for a long time, your dose shouldn’t have to be increased in order for you to get the same benefit, says Wise. “People often worry that they’re going to develop an addiction to inhalers, but really that’s not common with COPD,” he notes. If you aren’t getting the same benefit from your medication, you should check in with your healthcare provider and make sure you are using your inhaler correctly, says Wise. “Sometimes in asthma, if people overuse their rescue inhaler, it can have less and less efficacy; but that’s usually a sign that their asthma is getting worse rather than that they’re developing intolerance to the medication,” he says.
6. Thrush or Candida Infection in Your Mouth
“If you have more irritation or soreness of the mouth or you notice whiteish patches on the tongue or the inside of the mouth, it could signal the presence of thrush, or a candida infection of the mouth,” says Wise. You should contact your doctor if you suspect you have thrush so that they can prescribe treatment for the infection.
7. Gastrointestinal Issues Such as Nausea, Diarrhea, or Weight Loss
In some of the oral medications prescribed for COPD, the most common side effects are GI upset, such as nausea, diarrhea, and weight loss, says Wise. Typically, this would happen when you begin taking the medicine, he adds. If the side effects are negatively impacting your quality of life, you should discuss it with your doctor.
