Understanding Bronchodilators, Corticosteroids and More COPD Medications

Understanding Bronchodilators, Corticosteroids and More COPD Medications

The Right COPD Medications for Symptoms

Although COPD can’t be reversed, the right COPD treatment can slow the progression of the disease, decrease pain and improve your quality of life.

Since COPD brings many serious and uncomfortable respiratory symptoms, most cases will require a careful combination of drugs to alleviate the various discomforts.

Your doctor will tailor a treatment plan to your case, but you have a responsibility to track your reactions and express any concerns that could signal a problem with the plan.

Effective Medication for Respiratory Symptoms

There are various types of medications used to treat COPD. Understanding what the different classifications of medicines do and when to take them can help you manage your COPD symptoms more effectively.

When it comes to COPD, there is not a one size fits all treatment plan. Every person is unique and medications prescribed may vary.

Fast-Acting Bronchodilators

Fast-acting bronchodilators work quickly to decrease symptoms of COPD, such as wheezing and shortness of breath. There are different fast-acting bronchodilators available, which your doctor may prescribe.

The drugs work by relaxing the muscles of your airway, which allows air to flow in and out of the lungs easier. Fast-acting bronchodilators can ease shortness of breath and wheezing. They typically start to work within minutes.

Side effects from fast-acting bronchodilators can include increased heart rate, nervousness, and tremor. A headache, nausea, and dizziness can also occur.

As with any medication, it’s important to discuss the risks versus the benefits with your doctor.

Long-Acting Bronchodilators

Long-acting bronchodilators are also used to treat COPD. This classification of medication also relaxes the airways, but it takes longer to work and its effects last longer.


A long-acting bronchodilator for COPD is considered a control medication. It is used to prevent or control symptoms, not to treat sudden shortness of breath.

Long-acting bronchodilators are usually taken once or twice daily. Side effects of long-acting bronchodilators are the same as those from fast-acting bronchodilators.


Corticosteroids are used to decrease airway inflammation that can occur with COPD. This type of medication is also a control medication used to prevent symptoms of COPD.

They are typically taken once or twice daily depending on the drug. Side effects of corticosteroids include weight gain, sore throat, and thrush, which is a yeast infection in the mouth.

Combination Medications

Combination medications are also available to treat COPD. They combine a long-acting bronchodilator with a steroid to prevent symptoms. Combination medications are taken daily as a control medication.

Common side effects of combination medications include those similar to bronchodilators and steroids, such as rapid heart rate, restlessness, and dry mouth.

Additional Medications

People with COPD are more prone to develop respiratory infections. In some cases, such as a bacterial infection, antibiotics may be prescribed.

Flu and pneumonia vaccines are also recommended for people with COPD since they are more likely to develop complications from respiratory infections.

How Are Respiratory Medications Taken?

Certain respiratory medicines may be available in pill form or liquid. But the most common way respiratory medications are taken through inhalation.


A nebulizer is a device that is used to turn liquid medication into a mist or aerosol, which is inhaled into the lungs. A nebulizer uses a small air compressor.

Medicine is placed in the nebulizer cup. Tubing is attached to the cup on one end and the air compressor on the other. When the machine is turned on, it creates a mist, which is inhaled using a mouthpiece or a mask.

Typically, it takes about five to ten minutes to breathe in the medication using a nebulizer. A nebulizer is easy to use, but the downside is it takes a little longer than inhalers.

Meter Dose Inhaler (MDI)

A metered dose inhaler is a device, which delivers a pre-measured dose of medication when you press on the canister. Inhalers require a little more coordination than a nebulizer, but they are small and portable.

Dry Powder Inhaler

Dry powder inhalers release respiratory medication in the form of a powder. To use it, you must inhale forcefully.

Certain medications only come in the form of a dry powder inhaler. Dry powder inhalers require a more forceful breath in on the user’s part than an MDI, so they may not be appropriate for everyone.


A Respimat is a new type of delivery device, which was approved in recent years. The medication in a Respimat is an aerosol or mist that is slow moving. It is considered a soft-mist inhaler.

It does not have a propellant and comes out slower than an MDI. The size of the particles in a Respimat allows the medicine to travel deeper into the lungs.

Using a Spacer with an MDI

If you use an MDI, it’s beneficial to take it with a spacer. An MDI without a spacer can be challenging to coordinate. Plus, some of the medication can end up on the back of your throat instead of the lungs.

A spacer can make taking an inhaler easier and more effective. A spacer is a tube-like device. The medication attaches to one end of the spacer. The other end has a mouthpiece for you to inhale through.

When you push the canister, the medicine travels into the chamber of the spacer. It allows you to inhale slower, which helps the medication travel deeper into your lungs.

Side Effects of COPD Medications

Side effects are common with many medications for COPD – especially when taken for a long time or when combined with other medications. Each person is unique and will experience side effects differently, but some of the most common include:

  • Weight gain and fluid retention (oral corticosteroids)
  • Osteoporosis (oral corticosteroids)
  • Dry mouth, sore throat or thrush (inhaled corticosteroids, bronchodilators)
  • Restlessness or anxiety (bronchodilators, methylxanthine)
  • Stomach upset and heartburn (bronchodilators, methylxanthine)
  • Rapid heart rate (methylxanthine, medications that combine a corticosteroid and a bronchodilator)

It can take time for your body to adapt to a new medication, and side effects can be stressful.

Do yourself a favor and stay organized: write out a list of your medications for your reference and your pharmacist’s records, and draw up an action plan with your doctor outlining how best to handle flare-ups.

A little bit of planning can save you a lot of pain and worry down the road.


American Lung Association (Managing Your COPD Medications)

American Thoracic Society (Medications Used to Treat COPD)

MaryAnn DePietroMaryAnn DePietro

MaryAnn DePietro CRT, has written extensively about medical conditions, such as COPD, asthma, and sleep apnea for various websites, magazines and newspapers. MaryAnn has a degree in Rehabilitation from Penn State University and a degree in respiratory therapy. In addition to writing, she works as a respiratory therapist at a trauma center in California.

Nov 20, 2017
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