Lungs – Your Lungs

Everyone takes breathing for granted… except those for whom it’s a daily struggle. That effort can result from a range of lung diseases and cures are hard to come by.

Lung cancer is probably the most well advertised, though – thankfully – it is becoming less so as a result of improved treatments. It is, paradoxically, one of the few conditions that can actually be cured. Through a combination of surgery, chemotherapy, and possibly radiation, a person can actually emerge from lung cancer with excellent prospects of a normal lifespan and lifestyle.

Sadly, those prospects are not quite so good for one of the millions of individuals afflicted with some form of COPD (Chronic Obstructive Pulmonary Disease). Whether chronic bronchitis or emphysema, or any of the lesser known obstructive lung diseases, no cure is known, yet.

However, they are easily diagnosed and there are several effective treatments for COPD that can ease symptoms. Through the use of bronchodilators for short-term relief and corticosteroids to improve long-term function, COPD sufferers can live fairly normal lives. Similar treatments for asthma have long been known and are used by millions of people of all ages.

For those who have contracted tuberculosis, the prospects are even better today. It is easily diagnosed with a simple skin test. And, because it is caused by a specific bacterium, it can be cured in most cases by any of a number of antibiotics.

As with any disease, of course, the best treatment is prevention. There is no guarantee, particularly because the underlying causes are often unknown, but an individual can drastically improve his or her odds through lifestyle choices.

Cigarette smoking, for example, is well-known as one of the major risk factors for a range of lung conditions. Lung cancer, COPD, and more are all about 10 times more likely among those who smoke a pack a day for years. Allergic asthma, while it isn’t caused by smoking, can be made worse by it, since it significantly reduces the body’s ability to deal with the disease.

Apart from avoiding harmful substances like smoke and industrial chemicals, positive factors can optimize lung health.

A diet rich in antioxidants may help lung tissue deal with irritants and invading organisms. Even caffeine and alcohol in moderation are beneficial. Regular, age-and-health-appropriate exercise helps bolster overall health. At the same time, it produces benefits which have a direct bearing on lung capacity and fitness. Keeping the home environment relatively free of fungi, dust, animal dander and other contaminants helps protect the lungs from harm.

Knowing how your lungs function under normal circumstances can help you see some ways to keep them in the best possible working order.

Lungs – What Is Emphysema?

Emphysema is one of the two major forms of COPD. It results when the alveoli are damaged. Those are the tiny sacs in the lung that exchange oxygen into and carbon dioxide out of the blood.

Picture the airways and lungs as an upside down tree, with a trunk (trachea or windpipe), branches (bronchi), twigs (bronchioles), and leaves (alveoli). Air flows into the trunk, passing progressively down until it reaches the alveoli. Under normal circumstances, O2 moves in and CO2 moves out.

But cigarette smoke, industrial chemical exposure, and other irritants can damage the walls of the small sacs, reducing the efficiency of the gas exchange. Emphysema makes the alveoli lose elasticity as inflammation sets in. The sacs become less effective at emptying air because they don’t contract far enough. That leaves gas trapped inside them.

Since that gas now has less O2 and more CO2, it doesn’t supply the blood with needed fresh oxygen and clear out the old carbon dioxide as much. Also, it takes up space that would be occupied by incoming oxygen-rich air. The net result is a feeling of shortness of breath (dyspnea), especially under mild exertion.

Tragically, the disease is often progressive. More and more alveoli enlarge, making them less elastic. A healthy lung will have about 300 million of these tiny sacs, but emphysema will, over time, reduce that by 30-50% or more.

As that gas exchange capacity is reduced, an individual has to exert increasing effort to expel air, to take in fresh oxygen and release CO2. The effort itself becomes increasingly uncomfortable. At the same time, because the body has less oxygen, fatigue sets in sooner than normal under conditions of moderate activity.

A chronic cough is common but not always present. It can easily be confused as a sign of chronic bronchitis, a disease that often occurs in conjunction with emphysema. In the case of emphysema, it much less often produces phlegm. Even here, though, because both forms of COPD make a person more vulnerable to lung infections because of the tendency to retain excess mucus, either may produce a yellow-green sputum as a secondary effect.

Since oxygen is required for all muscular activity, even eating may become difficult. Also, while eating, breathing is reduced. When a person eats, the stomach expands, pushing up the diaphragm (the major muscle used to expand the lungs). That compresses the lungs, making it harder to breathe.

There is no cure for emphysema, but there are activities that can help compensate.

Breathing exercises emphasize methods for optimizing airflow. For example, something as simple as pursing the lips during exhaling can help. That technique creates a small resistance to the outflow of air. That in turn increases slightly the air pressure on the airways, keeping them as open as possible.

Another simple technique alters the way you would naturally breathe. Because it takes longer for less elastic alveoli to expel air, short breaths in, followed by longer exhalations out can help maximize airflow. A variation involves holding your elbows back to arch your chest, then hold the inhaled air in for a few seconds. That is followed by forcing air out more strongly than normal and moving the elbows back to a natural position.

Of course, any diagnosis and treatment should be performed by a physician. He or she will perform a physical exam, followed up by a series of pulmonary function tests. If emphysema is suspected, a set of follow-on tests, such as a tissue exam after a biopsy, will generate a definitive diagnosis. On that basis, your doctor can recommend a treatment regime to help alleviate symptoms.

Lungs – What is COPD?

COPD is an acronym that stands for Chronic Obstructive Pulmonary Disease. It is used as a generic term to cover chiefly chronic bronchitis and emphysema, since these are the two major lung diseases which obstruct airways.

Official estimates of COPD victims range everywhere from 12 million to 32 million in the U.S. alone. According to the Merck Manual, it is the 4th leading cause of death in the country, killing more than 120,000 people each year.

In chronic bronchitis the lining of the bronchial tubes (branching off the trachea and leading to the alveoli) become swollen and fill with mucus. That blocks airflow and increases chest pressure. In emphysema, the alveoli (the tiny sacs that exchange oxygen and carbon dioxide into and out of the blood) themselves become irritated.

Ironically, the obstructive character of COPD doesn’t reduce air intake. It actually traps air inside the lungs, reducing the efficiency of exhalation. That makes it harder to breathe. Also, it lowers the number of capillaries in the alveolar walls, reducing the efficiency of oxygen-CO2 exchange that is central to respiration.

Subsidiary effects are then produced.

One, for example, is increased blood pressure in the arteries, as the body tries to compensate for lower oxygen levels. At the same time, the disease stimulates bone marrow (the source of new red blood cells) to increase production.

The exact causes of COPD are not known, but there are several risk factors strongly correlated with the disease.

Long-term cigarette smoking is known to irritate airways and injure the ability of alveoli to recover from its effects. Occupational exposure to certain chemicals and dust (such as one type of asbestos not commonly used in buildings) are another risk factor. Genetics plays a role, though how large and exactly how is still under investigation.

Symptoms of COPD include a newly developed chronic hacking cough, one that isn’t an effect of a cold and persists for more than a couple of months. The cough typically produces sputum, which can be examined as part of a diagnosis. Shortness of breath, called dyspnea, is an overwhelmingly common symptom among COPD sufferers, since both chronic bronchitis and emphysema reduce oxygen-absorption efficiency. Patients may also cough up blood, an event known as hemoptysis.

However, since all these symptoms can also accompany lung cancer and other diseases, only a professional diagnosis can determine the actual condition. Other symptoms will be taken into account during that procedure, including cyanosis, for example. Due to reduced oxygen absorption, the skin turns slightly bluish. Physicians can also gain clues from the shape of the chest, since COPD tends to produce a barrel shape from muscle realignment as the body compensates for the disease.

Tragically, many COPD cases are progressive. However, while there is no known cure for COPD in any of its forms, treatments can lessen the severity of symptoms and prolong survival. Changes of lifestyle are often imperative, such as cessation of smoking and reduced activity. But with accurate diagnosis and proper treatment, COPD need not be fatal.

Lungs – What Is Chronic Bronchitis?

Introduction

Chronic bronchitis is an inflammation of the airways (the bronchi), resulting in excess mucus production. Though infections often result from this form of COPD, they are not typically the cause. An infection may produce acute bronchitis, a similar condition which can last days or weeks, but chronic bronchitis is persistent, lasting months or (more often) indefinitely.

Description

The linings of the airways contain cells that naturally produce mucus. The body uses it to trap irritants and disease-causing organisms. Small hair-like structures called cilia then move the mucus up the airway where it can be coughed up or swallowed. That process is actually healthy, since it clears harmful substances from the body.

Unfortunately, chronic bronchitis causes the body to produce more mucus than the cilia can handle and, at the same time, the cilia themselves tend to become weaker. As a result, a chronic cough can exist. That cough typically produces white or clear sputum (phlegm). The presence of yellow-green sputum is a sign of a secondary infection, often from a virus such as influenza.

Though sometimes called “smoker’s cough”, individuals can contract CB without ever smoking. Still, while the underlying causes are not known, smoking is one of the major risk factors. It is also possible to get bronchitis from repeated, heavy exposure to chemicals such as ammonia, sulfur dioxide, and others. Usually, though, that type of bronchitis clears up after exposure is discontinued.

The cough tends to be worse in the morning, since mucus accumulates in the airways during sleep. In advanced cases, especially when accompanied by a secondary infection, sleep may be disrupted. Those afflicted may find it helpful to sleep sitting up, at least temporarily.

Diagnosis

There are several preliminary tests called PFT (Pulmonary Function Tests) that are performed to diagnose chronic bronchitis and distinguish it from emphysema, asthma, and other lung diseases.

In addition, an ordinary x-ray may be used. However, since (at least until the disease is far advanced), it may tell a physician little. They’re typically taken anyway to rule out lung cancer or other possible problems. Instead, a CT or PET scan is often recommended in order to get a clearer picture of the lungs and airways.

Prognosis

There is no known cure for chronic bronchitis. In rare cases, the condition may reverse itself. Typically, though, it persists and often gets progressively worse over the years. However, it need not be fatal, since patients with moderate cases can have a fairly normal life span. Since it tends to begin around age 50 or later, mortality may well result from any other cause.

Drugs, such as corticosteroids, can be used to treat symptoms and ease discomfort. However, they have harmful side-effects when used long-term and physicians will weigh many factors before recommending them. Fortunately, there are several other alternatives.

Lifestyle changes are generally a must, particularly stopping any smoking and limiting exposure to second-hand smoke. Some exercise can help maintain lung capacity, but reduced activity and more moderate workouts are usually recommended.

Lungs – Smoking and Lung Problems

The association between heavy, long-term smoking and lung problems has been recognized for over 150 years. As early as the 1860s, physicians were warning patients about the relationship between the habit and breathing problems. Modern research has only served to make that link clearer and more well-founded.

There are over 4,000 chemicals in cigarette smoke that are potentially harmful. Not all are present in significant amounts, to be sure, but nicotine and other known-carcinogens (cancer-causing compounds) are. Several of them, under the heat of combustion of the tobacco leaves, bind together to form tar, a known lung-injuring compound.

Tar acts in two ways to produce stress on various parts of the lungs. Because of its sticky nature, it clings to cilia, the short, hair-like structures that line the airways (the bronchi and bronchioles). There, they hinder the natural action of the cilia. Here’s how…

Mucus producing cells in the airways are stimulated when irritants contact them. Smoke, dust, and small organisms are trapped by the mucus and the cilia move upward in a coordinated way to push that phlegm back up the passages. From there, natural muscular action coughs it up, spits it out, or swallows it.

Tar hinders the ability of cilia to perform that function. At the same time, other chemicals stimulate excess production of mucus, making it harder for the already-weakened cilia to operate. Other chemicals in cigarette and cigar smoke contribute to the breakdown of those natural clearing mechanisms. Pipe smoke will too, but it is less likely to be inhaled, and hence tends to affect the throat, tongue, and lips more than the airways.

At the same time, tar and other substances from smoke tend to migrate far down into the lungs, ultimately reaching the end-points: the alveoli. These are the tiny sacs at the terminus of the bronchioles that exchange CO2 out of and oxygen into the bloodstream. That exchange is the primary function of breathing.

The mere physical presence of tar particles tends to interrupt the function of the alveoli, since they occupy space that would otherwise contain air or CO2. But, in addition, several compounds in cigarette smoke tend to weaken the walls of the alveoli and otherwise damage their natural function.

Over time, the effect builds up as can be seen by the black stains visible on a smoker’s lungs. Gradually, lung capacity is reduced. Over a period of years, the chemicals continue to injure all the parts of the lung and airways, representing a major risk factor for COPD, including chronic bronchitis and emphysema, as well as other lung diseases.

The odds of a long-term, pack-a-day smoker contracting these conditions is about 10 times higher than a person who never smoked. Fortunately, quitting now can reduce your odds of disease to near the levels of a non-smoker. After about five years of non-smoking, most individuals chances of contracting lung cancer, for example, are only somewhat higher than those of a smoker.

Lungs – Lung Cancer Treatments, A-Z

Today, there are lung cancer treatments in a wider variety than ever. While none are pleasant, they have advanced to offer the least harm with the best possible chances of recovery. Early detection remains highly desirable, since it makes possible the greatest array of options.

Treatment options depend, of course, on the type and stage of lung cancer. Stages are numbered I-IV (smaller numbers are less severe) and the lower number typically is treated with surgery. The higher numbers often call for combinations of surgery, chemotherapy, and radiation.

Naturally, only your physician – after a thorough diagnosis and consultation with a specialist – can recommend which is best.

Surgery

For most early-stage carcinomas surgery is recommended.

If the tumors are small and well-confined a procedure called a wedge resection may be performed. In this technique, a small section containing the tumor and a surrounding thin layer of healthy tissue is removed.

A lobectomy is the next step up, used for more advanced cases in which the tumors have grown in size and/or multiplied, or populate several areas of the lung. Here, an entire lobe of one lung is surgically removed. When the cancer has spread to make that insufficient, an entire lung may be removed, a procedure called a pneumonectomy.

In some cases, when the surgeon deems it warranted at the time, some lymph nodes in the chest may also be removed. The lymph system carries a type of fluid throughout the body, more or less in parallel with the blood vessels. That makes it a tragically efficient delivery vehicle for spreading cancer cells throughout the body. If the cells are believed to have entered one or more lymph nodes, removing them can forestall that problem.

Chemotherapy

When lung cancer has reached Stage II or beyond, chemotherapy is usually called for. Dozens of drugs are available for reducing in size or destroying tumors and often a ‘cocktail’ of them is special-made for each patient.

In some cases, the drugs are delivered intravenously, in others, orally. The goal is to kill the cells without doing excess damage to the patient, though side-effects usually involve nausea and other ill-effects, such as hair loss. Depending on the type of tumor and individual circumstances, physicians may use a combination of surgery, followed by chemotherapy ‘just to make sure’.

Treatment regimes can last a few weeks to a few months. Newer therapies involve use of more targeted drugs, in an attempt to destroy only the tumor cells and reduce side effects. Bevacizumab, for example, works by reducing the tumor’s ability to grow (something it enables by increasing nearby blood vessels for its own nourishment). Erlotinib, by contrast, blocks the chemical signals that tell tumor cells to divide.

Radiation

Radiation, usually a source of x-rays or gamma rays (high-energy, invisible light), is one of the oldest of the modern treatments.

Treatment techniques vary, but in one form a small piece of radioactive substance (such as radioactive Cobalt or Iodine) is placed near the tumor and the rays it emanates kill nearby tumor cells. The radiation disrupts the ability of the cells to divide, since it destroys their DNA.

While excess radiation is known to produce cancers, in regulated dosages and correctly targeted, it can destroy tumors. The trick, of course, is to destroy the tumor while doing minimal damage to surrounding tissues and organs, which can create more problems than it solves.

Fortunately, thanks to advanced technology and improved understanding of radiations effects, that is possible. Still, because of its inherent risks, it is often only recommended for more advanced cases and is used in conjunction with other treatment options.

Lungs – Lung Cancer Symptoms to Watch For

As with nearly any disease, the symptoms of lung cancer can overlap those of many other conditions. Still, there are a number of common things that anyone can watch out for.

Coughing is a common behavior. We do it spontaneously when anything irritates the airways. But a new cough that persists for a few weeks in the absence of a cold should be checked out. That is especially true for those with a history of smoking and/or cancer in the immediate family. Such coughs can get worse over time, again not leading to any specific diagnosis. To obtain a definitive diagnosis requires a physician.

One distinctive indicator is coughing up blood. Any rupture in the blood vessels along the airways can produce that. It can also be completely irrelevant, since a lesion in the throat or sinuses may be the root cause. But lung carcinomas, as they are called, are a common result of hemoptysis and occurs in a large percentage of cases.

Prolonged coughing for any reason can produce chest pain. But chest pain in the absence of coughing is also cause for concern. It may be simple heart burn, and often is. It may be unrelated to lung tumors, produced by an incipient heart condition. But the pain produced by lung tumors tends to be dull and persists over weeks. Since it occurs in about 25% of patients, it is one more suggestive piece of evidence. As a common symptom of lung cancer, it should be reported to your doctor.

Shortness of breath and wheezing are two more common signs of lung cancer. As tumors spread they can block airways and produce fluid in the lungs, a condition known as ‘pleural effusion’. Wheezing can result from inflammation that often accompanies lung cancer. Unfortunately, here again, these two symptoms can occur with a variety of diseases and only a professional diagnosis can say which is responsible.

Similarly, respiratory infections can result from bacteria, fungi, and other invasive organisms in the pulmonary system. But repeated infections that persist, as occurs in bronchitis or pneumonia, are often the result of underlying lung carcinomas.

Since cancers can spread – a process called metastasis – tumors that begin in the bronchi can produce other symptoms as they spread and affect other organs. Bone pain in the vertebrae, for example, can occur when tumor cells migrate into the soft material inside bones. Lung cancer that spreads to the brain can affect vision.

But self-diagnosis can be misleading. Lung cancer, even when it spreads through the lymph system to affect other areas, may produce no symptoms at all. Metastasized tumors may grow in the adrenal glands or the liver, yet produce no symptoms until long after other areas are affected. Whether the signs become obvious depends greatly on how large those tumors become.

Indeed, about 25% of patients in whom lung cancer is found have no symptoms at the time of initial diagnosis. The carcinomas are often discovered only as part of a chest x-ray or other routine procedures. As such, it is important that regular check-ups include x-rays and other work, especially for those who smoke and/or have a history of cancer in the family.

Lungs – Diagnostic Tests for Lung Cancer

When a patient reports any of the symptoms of lung cancer, or something suspicious shows up on an x-ray, the next step is to obtain a definitive diagnosis. There are fortunately a wide-array of modern techniques to carry that out. An x-ray, for example, can display worrisome shadows, but other tests will show for sure whether or not a type of carcinoma exists.

X-rays can be supplemented with a CT scan. (CT stands for computer tomography, an imaging technique.) A PET scan (positron emission tomography) can provide a more extensive visual depiction of the area. A harmless radioactive isotope is injected to ‘light up’ certain areas, since tumor cells absorb the material differently than normal cells do. Radiologists can then examine the results.

But an actual sample of lung tissue remains one of the best methods of detecting tumors. It is obtained by a biopsy, which can be carried out in a number of ways.

Bronchoscopy is a common method for obtaining a sample. With the patient under anasthesia, a physician passes a flexible tube down the throat or through the nose. At the end of the tube are small ‘scissors’ that clip off a tiny piece of tissue. The sample is sent to a pathologist, who looks for characteristic tumor cells.

Another common method for obtaining a tissue sample is a technique called ‘fine needle aspiration’. A thin needle can be inserted into a lymph node near the lungs, which then sucks in a few sample cells. The fluid is given to a pathologist who once again looks for the signs of a tumor.

A more invasive technique may be required, such as mediastinoscopy. In this method, a small incision is made at the base of the throat. The physician guides a small tube through the slit and down into the lymph nodes in the chest.

Since one symptom of lung cancer is fluid in the lungs (a condition known as ‘pleural effusion’), extracting some of that fluid can give doctors clues. A technique called thoracentesis is used to obtain the fluid. A physician inserts a thin needle through the chest wall between the ribs. The liquid is then sucked up through the needle and examined for evidence of cancer cells.

There are supplemental data and tests that a physician will use in the diagnosis of lung cancer.

A medical history is important, since many choices (such as smoking) increase the odds of cancer. A family history is recorded, since genetic factors play a role. Pulmonary function tests, such as spirometry, help determine how efficiently the lungs are operating.

Lung cancer develops in about 1/4 of cases where patients show no symptoms at all in early stages. So, early detection is vital to provide the widest number of treatment options and the best possible chances of full recovery.

Lungs – Diagnostic Tests for COPD

COPD (Chronic Obstructive Pulmonary Disease) is a generic term used to cover two conditions – chronic bronchitis and emphysema. Both cause obstruction of the airways, though in different ways, and reduce oxygen-CO2 exchange efficiency.

As a result, detailed tests are required to distinguish the two diseases. But a set of generic tests which measure airflow, blood oxygen levels, and other factors are still used in an initial diagnosis of COPD.

Spirometry

The first of those tests, spirometry, involves measuring lung capacity.

Spirometry is a simple, non-invasive, air-time measurement test performed in a doctor’s office. The patient inhales deeply then breathes into a tube and the amount of air exhaled is measured.

Three technical variables, called FEV1 (Forced expiratory volume after 1 second), FVC (Forced Vital Capacity), and FEF25-75 (Forced Expiratory Flow at 25%-75%) allow the physician to rank the output. When the results are about 70% of the volume exhaled by a healthy person, COPD of some type is almost assured.

The test is often run multiple times, and a variation called post-bronchodilator spirometry will sometimes be performed. In this test, the patient is given a bronchodilator to relax and expand the airways. The doctor then performs the standard spirometry test and observes the results. Apart from helping to confirm the diagnosis, this variation indicates whether the reduction in lung capacity is reversible.

Lung Volume

In addition to spirometry, the lung volume can be indirectly measured, either with gas dilution or body plethysmography.

In gas dilution, the patient inhales nitrogen or helium instead of air. The volume distribution of the gas is measured as a proxy for lung volume.

Body plethysmography is carried out with the patient in an airtight chamber. He or she then inhales and exhales through a tube and a machine records pressure changes in the plethysmograph to calculate the volume of air the lungs can hold.

The results of the tests are adjusted for height, age, and other individual factors to compare against averages across the population.

Diffusion Capacity

Since the primary function of the alveoli (the tiny sacs at the end of the bronchioles or airways) is to enable gas exchange (of O2 and CO2), a measure of their diffusion capacity is diagnostic.

In this test, the patient inhales a small amount of CO (carbon monoxide). In large amounts it is toxic, but at the levels of the test it is perfectly safe. The amount taken up into the blood is measured by extracting a blood sample and measuring the CO content. This is one way in which emphysema is detected.

Oximetry

Similarly, the amount of dissolved oxygen in the blood provides useful information for diagnosing COPD. There are several ways to go about it.

One test takes a sample of arterial blood and measures the oxygen content. But the test is somewhat painful since extracting blood from an artery is more uncomfortable than from a vein (the usual method). So, an alternative called oximetry is sometimes used.

In this method, a device shines a light through the finger or thumb and the amount transmitted is measured on the other side. Since the amount of light is related to how much oxygen is in the blood, the device can make a non-chemical measurement without requiring a sample. The downside is that the test is less accurate than measuring arterial blood gases (ABG).

Summary

Once these tests are completed your physician will have considerable information on which to base a diagnosis. If COPD is strongly suspected, he or she may recommend follow up tests and begin to form a recommended course of treatment.

Lungs – COPD Treatments

Tragically, there is no cure for chronic bronchitis or emphysema, the two major types of COPD (Chronic Obstructive Pulmonary Disease). But there are a wide variety of symptom treatments that can ease discomfort and improve daily life.

Stop Smoking

The first rule of medicine is ‘do no harm’. The first rule of treating COPD for each patient is ‘do no MORE harm to oneself’. Therefore, stopping smoking is a must, if you smoke.

Even if smoking didn’t cause the disease, it will definitely contribute to any deterioration that takes place in this progressive condition. Smoking is one of the most common risk factors of COPD and an irritant of airways and alveoli. Damage to those two major components of the lungs are present in the condition.

Fortunately, for those without the willpower, there are several aids to stop smoking. Everything from Nicorette gum to nicotine patches are available as substitutes. Certain antidepressants, such as Bupropion, have been found to decrease cravings. Varenicline can help reduce withdrawal symptoms.

Drug Therapies

Though no drug restores bronchioles or alveoli health, nor slow their deterioration, there are several that can improve breathing and ease symptoms.

Corticosteroids

One of the oldest treatments for chronic bronchitis and emphysema are corticosteroids. Prednisone and prednisolone are still used in more serious cases and help about 20-30% of patients.

However, long-term use of corticosteroids have long been known to have serious side effects. Among them include: osteoporosis, increased risk of diabetes, high blood pressure, and excess weight gain. Administration by inhaler rather than pill carries fewer side effects.

As a result of these drawbacks, corticosteroids are sometimes recommended only for more advanced cases where other options have not shown adequate results.

Bronchodilators

Bronchodilators are one of the most common and helpful treatments for COPD today. They’re similar to the drugs used to treat asthma. They relax the muscles surrounding the airways and can be taken as a pill or via an inhaler. Some high-strength forms are even injected intravenously.

Inhalers tend to be preferred, since they produce the fewest side effects. One form in particular, MDIs (metered dose inhalers), use a pressurized container to optimize delivery of the drug to air passages. Some skill is required to use them properly, though, in order to prevent excess medication from being deposited on the tongue and throat.

Beta-agonists

Another class of asthma medications used to treat COPD are beta-agonists. They bind to targeted molecules of the airway muscles and help relax them to relieve constricted passages, making breathing easier. The effect is to relieve shortness of breath, a condition called dyspnea.

In some types, the effect begins within a few minutes and can easily last a few hours. There are types, such as Serevent and Foradil, that have a slower onset but last up to 12 hours. However, the effectiveness of beta-agonists tends to decrease over time.

Anti-cholinergic Drugs

Acetylcholine is a chemical released by nerve cells that affects nearby muscles. Its effect is to contract them, leading to reduced airflow. So-called anti-cholinergic drugs like Atrovent can counteract that. It is usually administered by an MDI device.

It helps relieve dyspnea, which makes it possible to engage in moderate exercise with less risk. Such exercises help maintain muscles, making them use oxygen more efficiently. That in turn eases the negative effects of COPD.