1 Bronchodilators

They are often prescribed first for COPD sufferers. Bronchodilators relax the muscles around the airways so you can breathe more easily. They can be short-acting (for immediate relief) or long-acting (used regularly to control symptoms). Short-acting bronchodilator inhalers are generally the first choice for COPD sufferers.

There are two main types of bronchodilators used in the management of COPD:

• Short-acting beta2-agonists (SABAs): examples include salbutamol, phenoterol, terbutaline and levalbuterol. Used for rapid relief of acute symptoms. The effect generally lasts 4–6 hours.
• Long-acting beta2-agonists (LABAs): examples include salmeterol, formoterol, arformoterol, olodaterol and indacaterol. These drugs provide long-lasting bronchodilation (12 hours or more) and are used regularly to control symptoms.

2 Anticholinergics

• Short-acting anticholinergics (SAMAs): ipratropium and oxitropium are examples. Like SABAs, they are used for rapid relief of symptoms.
• Long-acting anticholinergics (LAMAs): examples include tiotropium, glycopyrronium, revefenacin, aclidinium and umeclidinium. LAMAs are used as maintenance therapy for long-term bronchodilation and symptom control.

Bronchodilators can be administered using a variety of devices, including inhalers or nebulizers. The choice depends on disease severity, individual preferences and your doctor's recommendations.

3 Inhaled corticosteroids

Reduce airway inflammation and help prevent flare-ups, which is particularly beneficial for people with frequent COPD flare-ups.

The efficacy of inhaled corticosteroids alone remains uncertain. However, combining them with long-acting bronchodilators appears more effective in improving lung function and reducing flare-ups than using each drug separately.

4 Mucolytics

Mucolytic drugs such as carbocisteine or acetylcysteine act by thinning the mucus in the bronchi, making it easier to clear by coughing. They help reduce flare-ups and hospital admissions for COPD sufferers.

5 Antibiotics

If there are signs of respiratory infection, the doctor may prescribe antibiotics to reduce the risk of exacerbation.

6 Possible questions to ask your doctor

• How long does it take for the effects of this medication to be felt?
• What are the possible side effects or risks associated with this medication?
• Are there any special precautions to take when using this medicine?
• How is it administered (orally, by injection, by infusion)?
• Are there any interactions with other medications or supplements I'm currently taking?
• How often should I have check-ups or monitoring appointments while taking this medication?
• What should I do if I experience side effects or adverse reactions?
• How long should I take this medicine?
• How does this drug fit into my overall COPD treatment plan?
• Are there any lifestyle changes or precautions I should take while on this medication?
• What should I do if I miss a dose?