The many medicines commonly prescribed for lung disease work in many different ways. These include:

• Relieving constriction of the bronchial tubes. This allows for better movement of air in and out of the lungs
• Relieving trapped air in the lungs
• Decreasing inflammation
• Decreasing mucus production or helping with mucus removal
• Preventing and/or treating exacerbations
• Fighting the infections that can come with an exacerbation

Some medicines are prescribed to be taken on a daily basis. Others should be taken only when the need arises. (This is called “PRN.”) You should review your list of medicines with your health care provider. Make sure you know how and when to take them. Your list can also help you and your health care provider discuss your concerns and address any questions.

Most COPD patients need to be on daily maintenance medicines. These medicines can make you feel better, breathe better and do more. They can also help prevent exacerbations. If your health care provider suggests you take these daily medicines, try to follow that advice. You may have concerns about side effects, effectiveness or cost. Discuss these issues with your health care provider. Most COPD patients cannot be successfully treated with “PRN” medicines alone.

Your medicine worksheet should include:

• All the medicines you are taking on a routine basis
• Medicines that you take only when you have certain symptoms
• The order and time of the day to take medicines
• The methods for a taking the medicines (e.g., pills, inhalers)
• A plan for adjusting dose levels or how often the drug is taken during exacerbations
• Any over-the-counter (OTC) or alternative medicines you are taking

In this chapter, you will learn:

• How can I figure out what my medicines are supposed to do? How will I know if I’m having side effects?

The following pages include descriptions of the most common medicines prescribed for COPD patients. This info should help you learn more about your own medicines. To simplify this
information, we have grouped types of medicines by how they work. In this way, we can describe many different kinds of drugs and their common side effects based on their “drug classifications”. We also have included some trade and generic names of drugs in each of these groups. New drugs are constantly becoming available. And generic versions of brand name drugs continue to be made. If your doctor has prescribed a medicine that you cannot find in these lists, ask your doctor to tell you the drug classification it is in. Or, you may want to share this chapter with your health care providers so they can review our recommendations. They will see how we have classified these common medicines. The information on the general drug classification will help you know what to expect from all drugs in the same group.

Each of these summaries includes a list of side effects that may be caused by a specific group of drugs. We have listed all of these potential side effects to alert you to the chance that these could occur. It does not mean that you can expect to have all or even any, of these effects. Some critical side effects are rarely seen. But they are listed so you can recognize them should they occur.

Some side effects, such as dry mouth, may be easily endured and treated. Others, such as abnormal heart rhythms, may require changes or stopping your prescribed medicines. Be aware that no list of side effects can include all the problems that an individual might have with a medicine. You should always discuss any side effects or strange symptoms you have with your health care provider. You need to be assured that you are getting the correct type and amount of your medicines.

• How can I know if I’m using my inhaler correctly?

Sometimes people have problems with inhaled medicines. It may seem like they are getting no benefit from the drug. Or the drug causes unpleasant side effects. So they wonder if they should stop taking these medicines. Many times, these problems can be traced to incorrect use of the inhaler. To help you avoid these problems, this chapter has detailed information about how to use and care for inhalers and nebulizers. A good option is to take your inhaler to your local pharmacist. Ask him or her to show you how to use it. This help is free. Another option is to join a pulmonary rehabilitation program. The respiratory therapists and other professionals at these programs are experts at using these devices.

• Can herbal medicines and supplements be used to treat lung disease?

Some people want to know if “alternative medicines” can be useful for improving their health and treating their lung disease. At the end of this chapter, we discuss the use of alternative medicines, such as herbal and vitamin supplements. At this point there is little hard evidence for their role, but future studies may better define this issue.

Now, let’s look at the description of benefits and possible side effects for the common medicines used to treat COPD.