COPD, or chronic obstructive pulmonary disease, encompasses bronchitis and emphysema, two lung diseases characterized by inflammation of the airways and excessive mucous production which block airways. According to Donna D. Ignatavicius, MS RN, and M. Linda Workman, PhD, authors of the 2006 edition of “Medical-Surgical Nursing: Critical Thinking for Collaborative Care” treatments for COPD aim to control symptoms of cough, shortness of breath and anxiety and improve quality of life.
Gerene Bauldoff, PhD, professor of clinical nursing at the Ohio State University in Columbus and author of When Breathing is a Burden: How to Help Patients with COPD, published in the December 2009 “American Nurse Today” journal reports COPD treatment consists of primarily 3 different kinds of bronchodilators. Beta2-agonists relax airways to improve airflow. These bronchodilators may be short-acting and useful as rescue inhalers, such as albuterol, or long-acting such as moterol. Bronchodilators reduce airway spasm, a cause of COPD cough.
Anticholinergics, another class of bronchodilators, achieve its smooth muscle relaxing effect by interfering with certain enzymes. Tiotroprium is one anticholinergic that opens airways, relieves bronchospasm and lasts 24 hours requiring once-a-day dosing. The third class of bronchodilators is methylxanthines. Physicians use this class of bronchodilators less frequently because when metabolized by the liver, methylxanthines convert into caffeine which can cause toxic effects.
Corticosteroids reduce airway inflammation relieving cough. The American Lung Association reports that corticosteroids prove most effective when used in COPD patients with chronic bronchitis. Bronchial inflammation and mucous production lead to frequent cough. Corticosteroids may be used long term or for brief periods of time when COPD exacerbations occur.
Treatments for COPD cough include the use of expectorants. Expectorants loosen mucous making it easier for the patient to cough up and expel the secretions. According to the ALA, primarily patients with chronic bronchitis benefit from expectorant use.
COPD patients use oxygen to relieve symptoms. Coughing worsens when patients feel anxiety from being short of breath. The ALA reports approximately one million COPD patients use oxygen therapy greater than 15 hours per day. Referred to as long-term oxygen administration, oxygen the not only relieves aggravating cough and anxiety symptoms but increases survival.
The use of pulmonary rehabilitation helps relieve cough by improving lung mechanics. Pulmonary rehabilitation creates a fitness program for COPD patients to increase energy levels and endurance which improve lung function and enhance mental state. Greater airflow through the lungs reduces COPD symptoms to include cough and improves overall quality of life. (SeeReferences2)
Avoid Environmental Triggers
Avoiding environmental triggers like allergens and respiratory irritants make other treatments for relieving COPD cough more effective. Patients with COPD need to avoid dust, pollen, chemical fumes and strong fragrances and smoke. The primary cause of COPD is smoking and many patients have difficulty quitting even when suffering from severe symptoms. Lifestyle changes may be difficult but the benefits outweigh the inconvenience.