How Medications Help to OPEN AIRWAYS

1
How Medications Help to OPEN AIRWAYS

• Learning What, Why and When of Medications for
  COPD

2
Management of COPD

• Step 1 Education and Self-Management
• By knowing yourself and how you feel, we will be
  able to use medications that will help you
  breathe easier feel better

3
What Should Patients with COPD Expect from
Treatment?

• To breathe more easily
• To be more active
• To spend less time in hospital
• To have fewer chest infections
• To feel better
• To enjoy life more

4
Stopping Smoking

• Best suggestion
• Slows the progression
• (Trying to quit is better than not at all)
• Ask, Advise, Assist
• New Products - Nicotine Inhalers along
  with Patches

5
Inhalers The Why, How and When

• A metered dose inhaler (MDI) delivers a specific
  amount of medicine in aerosol form.
• This makes it possible to inhale the medication,
  instead of taking it in pill form.

6
Proper Inhaler Technique

• Take off the cap and shake the inhaler well.

7
Getting Ready

• Tilt your head back slightly and breathe out
  slowly and completely.

8
Holding Your Inhaler

• Hold the inhaler 1 to 2 inches in front of your
  mouth (about the width of two fingers) or place
  inhaler in your mouth or use a Spacing Device.

9
Breathe Then Press

• Start breathing in slowly through your mouth, and
  then press down on the inhaler one time. Breathe
  in slowly, as deeply as you can.

10
Hold Your Breath

• Slowly count to 10 while you hold your breath (if
  you can). This lets the medicine reach deep into
  your lungs.

11
Repeat as Directed

• If your doctor prescribed more than one puff
  of medicine, repeat this procedure,
  starting with step 2.
• For inhaled quick-relief
  medicine (beta-agonists), wait about one
  minute between puffs. There is no need to wait
  between puffs for other medicines.

12
Rinse Mouth

• Rinse your mouth afterward to help reduce
  unwanted side effects.
• Do not swallow the water since this may increase
  chance of absorption into your system rather than
  your lungs.

13
Spacing Devices for Inhalers

• Spacers have holding
  chambers with valves
  that holds the
  medication inside the
  chamber until you
  breathe in again
• More likely to receive
  the full benefit of
  the medication
  
  

14
Short Acting Bronchodilators and Anti-Cholinergics

• Short-acting bronchodilators - Salbutamol
  (Ventolin), and Ipratropium (Atrovent) improve
  lung function and help you to be more active with
  COPD.
• Combination Product Combivent
• Last 4-5 hours so need longer acting product as
  well

15
Examples

• Ipratropium (Atrovent)
• Salbutamol (Ventolin)

16
Long-Acting Bronchodilators and Anticholinergics

• The Longer Acting forms - Salmeterol (Serevent),
  and Tiotropium (Spiriva) provide
• More sustained opening of airways
• Less breathlessness
• Improved quality of life with less exacerbations

17
Examples

• Salmeterol (Serevent)
• Tiotropium (Spiriva)

18
Inhaled Corticosteroids

• Reduces inflammation swelling in lungs
• New study suggests that Inhaled Steroids can
  improve lung function increase survival
• Taken after Bronchodilators (i.e. Ventolin,
  Atrovent and then Flovent)
• Important to rinse mouth after use

19
Examples

• Fluticasone (Flovent)
• Budesonide (Pulmicort)

20
Combination Inhalers

• Advair
• Symbicort

21
Other Medications

• Oral Prednisone
• Anti-inflammatory
• Has Side Effects so usually used for exacerbation
  along with antibiotics
• Antibiotics
• Used for exacerbation - important to change
  types of antibiotics (Remember that antibiotics
  are used for infection and that we may not always
  have a fever with infection)

22
Influenza Vaccine

• Annual Influenza vaccination is recommended for
  all COPD patients without a contraindication.
• Influenza infection often results in
  hospitalization
• Annual Influenza vaccination reduces chance of
  developing influenza and risk of death
• Pneumococcal vaccine should be given at least
  once and repeated every 5-10 years in high risk
  COPD patients.

23
Questions

• Ask your Pharmacist, Physician
• Have Your Pharmacist
  or Physician check
  your inhaler technique
• Information The Lung Association, Canadian
  Thoracic Society