Diagnosis. Treatment

Diagnosis

Tests may include:

· Lung (pulmonary) function tests. These tests measure the amount of air you can inhale and exhale, and whether your lungs deliver enough oxygen to your blood. During the most common test, called spirometry, you blow into a large tube connected to a small machine to measure how much air your lungs can hold and how fast you can blow the air out of your lungs. Other tests include measurement of lung volumes and diffusing capacity, six-minute walk test, and pulse oximetry.

· Chest X-ray. A chest X-ray can show emphysema, one of the main causes of COPD. An X-ray can also rule out other lung problems or heart failure.

· CT scan. A CT scan of your lungs can help detect emphysema and help determine if you might benefit from surgery for COPD. CT scans can also be used to screen for lung cancer.

· Arterial blood gas analysis. This blood test measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide.

· Laboratory tests. Lab tests aren't used to diagnose COPD, but they may be used to determine the cause of your symptoms or rule out other conditions. For example, lab tests may be used to determine if you have the genetic disorder alpha-1-antitrypsin deficiency, which may be the cause of COPD in some people. This test may be done if you have a family history of COPD and develop COPD at a young age.

Treatment

« Many people with COPD have mild forms of the disease for which little therapy is needed other than smoking cessation. Even for more advanced stages of disease, effective therapy is available that can control symptoms, slow progression, reduce your risk of complications and exacerbations, and improve your ability to lead an active life.

« Quitting smoking

« The most essential step in any treatment plan for COPD is to quit all smoking. Stopping smoking can keep COPD from getting worse and reducing your ability to breathe. But quitting smoking isn't easy. And this task may seem particularly daunting if you've tried to quit and have been unsuccessful.

« Talk to your doctor about nicotine replacement products and medications that might help, as well as how to handle relapses. Your doctor may also recommend a support group for people who want to quit smoking. Also, avoid secondhand smoke exposure whenever possible.

« Medications

« Several kinds of medications are used to treat the symptoms and complications of COPD. You may take some medications on a regular basis and others as needed.

« Bronchodilators

« Bronchodilators are medications that usually come in inhalers — they relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day or both.

« Examples of short-acting bronchodilators include:

« Albuterol (ProAir HFA, Ventolin HFA, others)

« Ipratropium (Atrovent HFA)

« Levalbuterol (Xopenex)

« Examples of long-acting bronchodilators include:

« Aclidinium (Tudorza Pressair)

« Arformoterol (Brovana)

« Formoterol (Perforomist)

« Indacaterol (Arcapta Neoinhaler)

« Tiotropium (Spiriva)

« Salmeterol (Serevent)

« Umeclidinium (Incruse Ellipta)

« Inhaled steroids

« Inhaled corticosteroid medications can reduce airway inflammation and help prevent exacerbations. Side effects may include bruising, oral infections and hoarseness. These medications are useful for people with frequent exacerbations of COPD. Examples of inhaled steroids include:

« Fluticasone (Flovent HFA)

« Budesonide (Pulmicort Flexhaler)

« Combination inhalers

« Some medications combine bronchodilators and inhaled steroids. Examples of these combination inhalers include:

« Fluticasone and vilanterol (Breo Ellipta)

« Fluticasone, umeclidinium and vilanterol (Trelegy Ellipta)

« Formoterol and budesonide (Symbicort)

« Salmeterol and fluticasone (Advair HFA, AirDuo Digihaler, others)

« Combination inhalers that include more than one type of bronchodilator also are available. Examples of these include:

« Aclidinium and formoterol (Duaklir Pressair)

« Albuterol and ipratropium (Combivent Respimat)

« Formoterol and glycopyrrolate (Bevespi Aerosphere)

« Glycopyrrolate and indacaterol (Utibron)

« Olodaterol and tiotropium (Stiolto Respimat)

« Umeclidinium and vilanterol (Anoro Ellipta)

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