These medications are inhaled steroids, which reduce swelling inside the airways. Often, these medications are taken daily. One should rinse the mouth and use a spacer to reduce the risk of a yeast infection in the mouth. The nurse will assist you to do this. Common anti-inflammatory medications are called Asmanex, Flovent, Pulmicort and QVAR. Occassionally, oral steroids are used when symptoms are getting worse. Common oral steroids used are Deltasone and Medrol.

These medications help to open your lung airways by relaxing the smooth muscle around the respiratory pathways. These medications can be short acting or long acting.

Short acting: These medications generally work quickly, within 15-20 minutes and are used as needed for shortness of breath. Often they are referred to as “rescue “ or “quick relievers”. Common types used are Proventil HFA, Ventolin HFA, Atrovent and Combivent.

Long acting: These medications have effects that last a long time and NEVER used during emergency shortness of breath. These types of medications open airways and keep them open. Common types that are inhaled every 24 hours are called Spiriva and Arcapta. Common types that are inhaled every 12 hours include Serevent, Foradil and Brovana.

Combination bronchodilator medications: Long acting bronchodilators may be combined with an anti-inflammatory medication to manage symptoms and are repeated every 12 hours. Two types that are commonly used are called Advair and Symbicort. Inhaled Devices: Medication is inhaled through the lungs and absorbed into the blood stream. Your primary care provider will decide which method is best for you. The nursing staff at the facility will help you by giving detailed instructions on the proper way in which inhalation medication is delivered. There are several types of ways this medication is administered. The different types of inhalation devices include:

1. Inhaled medicine with dry powder (DPI): To use, exhale away from the device, then put the mouthpiece in your mouth and breathe quickly. Ask the nurse to help you become proficient at using this device.
2. Metered Dose Inhaler (MDI): To use, remove the cap and hold the mouthpiece at the bottom. Shake the inhaler to mix the medicine. Seal your lips around the mouthpiece and tilt your head slightly. Open your mouth wide and breathe out, then begin a slow, deep breath while pressing the inhaler at the same time. Keep breathing deeply and slowly for 3-5 seconds, then hold your breath for 10 seconds. Resume normal breathing. Ask the nurse to help you become proficient at using this device.
3. Breath Activated Medication: This is a metered dose inhaler that releases a medicine “mist” when inhaled. One must merely seal their lips around the mouthpiece and breathe deeply with steady moderate effort. Ask the nurse to help you become proficient at using this device.
4. HFA Propellant: This inhalant has a different product as a propellant than a metered dose inhalant. Ask the nurse to help you become proficient at using this device.
5. Nebulizers: A nebulizer treatment is medication delivered through a machine that compresses air to create a mist of medication. A face mask is used and the medication is inhaled for about ten minutes. The nurse will set up the machine to deliver medication through the nebulizer. Before being discharged, the nursing staff may review instructions for the use of the nebulizer device.

Medicines for a cough are sometimes prescribed to liquefy thick secretions or inhibit coughing spasms. Try to control coughing at other times by avoiding very cold or hot fluids at bedtime.

Elevate the head of your bed allowing full lung expansion and place pillows placed under your arms.

Oxygen can be delivered from a tank, cylinder or concentrator. A thin, flexible cord can deliver oxygen through prongs inserted into your nose or through a mask. Concentrators require electricity to operate. Some people only require oxygen during exercise, activities or during sleep. People with severe COPD require oxygen continuously. It is important that you do not set oxygen above your physician recommended rate, too much oxygen can cause a negative reaction for people with COPD. Mild side effects related to prolonged oxygen use include a reduction to the sense of smell and taste.

The facility can provide annual influenza injections and periodic pneumococcal immunization when ordered by your Primary Care Provider. It is very important to avoid contact with infected people, reducing the risk of getting an infection in your respiratory system. Please tell your visitors how important it is to refrain from coming if they are feeling ill.

Medications may be prescribed to reduce anxiety. Anxiety can produce ineffective breathing patterns. Relocate to a quiet and calm environment when breathless. Therapists will model and instruct you on methods to breathe better when feeling anxious.

Suggestions include:

• If breathing becomes rapid, leaning forward can diminish the use of the accessory muscles and enhance the use of the diaphragm muscle.
• Pursed lip breathing also is effective to prolong exhalation (breathing out) and prevents air trapping and air gulping