What If COPD Medications Don’t Work?

Steps to Take If Your COPD Medications Don't Work

As an RN who has spent several years working on a telemetry unit, I worked with a lot of patients who had COPD. In fact, many of my patients were admitted for COPD exacerbations. One of their complaints? “My COPD medication stopped working!"

We’d often see the same patients over and over. At the time, I’d wonder if these patients were telling the truth, or merely making excuses for not taking their medications.

I’ve since learned that some patients don’t take their medications as prescribed, but they typically have a reason for doing this, such as the inability to afford their medications. Then, there are some patients whose COPD symptoms and condition worsen, despite their best efforts.

So, here are some tips for you, if your COPD is worsening and your COPD medication just isn’t cutting it.

Let Your Physician Know…

This may seem obvious, but the first step you should take is to let your physician know. There are several reasons for this.

The first reason is that if your condition is deteriorating rapidly, your physician is the best person to give you advice as to if you can manage your condition at home, if you should have a loved drive you to the emergency room, or if you should call an ambulance.

The second reason is that your physician can take a look at the COPD medications you are prescribed. If the ones that you are taking aren’t working, there is likely something that can be switched! Perhaps there is a better alternative.

Check Your Technique…

I learned from a respiratory therapist that I used to work with that many people do not use their inhalers correctly. Why? Because when they are prescribed, there is rarely any education as to how to use them.

A prescription is written and handed to the patient, and then it is taken to the pharmacy. Then, the inhaler is handed to the patient. See what happens? There’s little discussion about how to use the inhaler!

In fact, it has been estimated by a study presented at CHEST 2007 that up to one-third of patients with asthma and COPD misuse their inhalers.

The American College of Chest Physicians (ACCP) studied this patient population and found that 32.1 percent of this patient population using dry powder inhalers (DPI) made at least one error – and the mistakes increased with age and severity of illness.

If you're not sure how to use an inhaler with COPD, NewLifeOutlook has an in-depth explanation about using the various types of COPD inhalers here.

Learn to Breathe…

When your inhalers just aren’t cutting it, there are several breathing techniques that you can perform that will help. Why are these techniques helpful? Because when you’re short of breath, your breathing worsens, and the worse that you are breathing, the more anxious you become! These techniques not only improve breathing but reduce anxiety.

Pursed lip breathing is a highly effective breathing technique. Here are the steps to perform this easy breathing technique:

1. Keep your shoulders and neck relaxed.
2. With your mouth closed, breathe in through your nose for two seconds.
3. Then, breathe out through your mouth for four seconds. Your lips should be pursed – hence the name “pursed lip breathing." You can also breathe out for two seconds if four seconds is too long.

This technique is especially beneficial for people with advanced emphysema. It helps to release trapped air in the lungs, as well as open the airways.

Belly breathing, also known as diaphragmatic breathing, incorporates the diaphragm while breathing, which is underutilized in our day-to-day breathing.

When you have COPD, you’re often using accessory muscles to breathe – which means you’re using your neck, shoulders, and back, so retraining yourself to use your entire lung is important. Here are the steps to perform belly breathing:

1. Lie on your back. Draw your knees up to your chest, or place your knees on a pillow.
2. Place on hand on your belly, and another on your chest.
3. Inhale slowly through your nose. As you inhale, note how your belly rises and focus on keeping the hand on your chest as still as possible.
4. Exhale through your mouth, with pursed lips. As you exhale, note how your belly falls first.
5. Repeat.

Huff Cough technique is beneficial for the removal of excess mucus production. Coughing, in general, can cause fatigue. This cough technique is designed to reduce fatigue while coughing. Here are the steps to perform this cough technique:

1. Sit in an upright, comfortable position.
2. Inhale, but inhale slightly deeper than you usually would.
3. Using your abdominal muscles to blow out the air in three breaths. While blowing out the air, make the sounds, “ha, ha, ha" as if you were trying to make steam on a mirror.