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Treatments and drugs
By Mayo Clinic staffThe most important step in any treatment plan for smokers with emphysema is to stop smoking; it's the only way to stop the damage to your lungs from becoming worse. But quitting is never easy, and people often need the help of a comprehensive smoking cessation plan, which may include:
- A target date to quit
- Relapse prevention
- Advice for healthy lifestyle changes
- Social support systems
- Medications, such as nicotine gum or patches and the prescription medications bupropion hydrochloride (Zyban) and varenicline (Chantix)
Other emphysema treatments focus on helping you feel better, stay more active and slow the progression of emphysema. They include:
- Bronchodilators. These drugs can help relieve coughing, shortness of breath and trouble breathing by relaxing constricted airways, but they're not as effective in treating emphysema as they are in treating asthma or chronic bronchitis.
- Inhaled steroids. Corticosteroid drugs inhaled as aerosol sprays may relieve symptoms of emphysema associated with asthma and bronchitis. Although inhaled steroids have fewer side effects than oral steroids do, prolonged use can weaken your bones and increase your risk of high blood pressure, cataracts and diabetes.
- GERD treatment. Symptomatic gastroesophageal reflux disease (GERD) aggravates airway disease in many people, so your doctor may recommend medications as well as life style changes to treat it.
- Supplemental oxygen. If you have severe emphysema with low blood oxygen levels, using oxygen regularly at home and when you exercise may provide some relief. Many people use oxygen 24 hours a day. Various forms of oxygen are available, as are different devices to deliver supplemental oxygen to your lungs.
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Pulmonary rehabilitation program. A key part of treatment involves a pulmonary rehabilitation program, which combines education, exercise training and behavioral intervention to help you stay active and improve your health and quality of life.
You'll receive help with smoking cessation and your nutritional needs, and you may learn special breathing techniques and ways to conserve energy. Because exercise can help to slow the decline of your lung function, you'll also be given an exercise program.
- Antibiotics. If you develop a bacterial infection like bronchitis or pneumonia, antibiotics are appropriate.
- Inoculations against influenza and pneumonia. If you have emphysema or other forms of COPD, experts recommend an influenza (flu) shot annually and a pneumonia shot every five years.
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Surgery. In an experimental procedure called lung volume reduction surgery (LVRS), surgeons remove small wedges of damaged lung tissue. Removing the diseased tissue helps the lungs work more efficiently and helps improve breathing.
In another surgery, called a bullectomy, doctors remove one or more of the large air spaces (called bullae) that form when the small air sacs are destroyed. This procedure can improve breathing.
- Transplant. Lung transplantation is an option if you have severe emphysema and other options have failed.
- Emphysema. American Lung Association. http://www.lungusa.org/site/apps/nlnet/content3.aspx?c=dvLUK9O0E&b=2060053&content_id={39330D56-C0E9-4D08-B98F-18EA7B3C410B}¬oc=1. Accessed March 4, 2009.
- Chronic obstructive pulmonary disease (COPD) fact sheet. American Lung Association. http://www.lungusa.org/site/apps/nlnet/content3.aspx?c=dvLUK9O0E&b=2058829&content_id={EE451F66-996B-4C23-874D-BF66586196FF}¬oc=1. Accessed March 4, 2009.
- What is COPD? National Heart Lung and Blood Institute, National Institutes of Health. http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html. Accessed March 4, 2009.
- Celli BR. Update on the management of COPD. CHEST. 2008;133:1451.
- Bruce ML, et al. COPD: Your role in early detection. The Nurse Practitioner Journal. 2007;32:25.
- Corbridge SJ, et al. Chronic obstructive pulmonary disease. AAOHN Journal. 2007;55:181.
- Rennard SI. Chronic obstructive pulmonary disease: Definition, clinical manifestations, diagnosis, and staging. http://www.uptodate.com. Accessed March 4, 2009.
- Weiss ST. Chronic obstructive pulmonary disease: Risk factors and risk reduction. http://www.uptodate.com. Accessed March 4, 2009.
- Ferguson GT et al, Management of stable chronic obstructive pulmonary disease. http://www.uptodate.com. Accessed March 4, 2009.
- Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global initiative for Chronic Obstructive Lung Disease. Medical Communications Resources, Inc. Accessed March 20, 2009.
