Medicines for COPD (chronic obstructive pulmonary disease)

What it is

COPD is a group of lung conditions, mainly chronic bronchitis and emphysema, in which the airways become persistently narrowed and the lung tissue is damaged, making it hard to empty the lungs. It is most often caused by long-term smoking, though air pollution, occupational dusts and, rarely, an inherited deficiency can contribute. Typical symptoms are breathlessness on exertion, a long-standing cough, phlegm and frequent chest infections. Unlike asthma, the airflow obstruction in COPD is largely fixed and does not return to normal, and symptoms tend to progress slowly over years. People with COPD are also prone to flare-ups, called exacerbations, in which symptoms worsen suddenly — often triggered by an infection — and these can be serious. Diagnosis is confirmed with breathing tests (spirometry) showing persistent obstruction.

How it is treated

Treatment aims to relieve symptoms, improve exercise capacity and quality of life, and reduce exacerbations and decline — not to cure the underlying damage. Stopping smoking is the single most important step and the only intervention proven to slow the disease, so it is offered and supported at every opportunity. Inhaled bronchodilators are the cornerstone of maintenance treatment: a short-acting reliever for symptoms, and one or two long-acting bronchodilators (a LABA and/or a LAMA) taken regularly. An inhaled corticosteroid is added for selected people — particularly those with frequent exacerbations or features suggesting steroid responsiveness — but, in contrast to asthma, it is not used by everyone and is always given alongside a long-acting bronchodilator. Beyond inhalers, vaccination, pulmonary rehabilitation and a personalised self-management plan are central parts of care.