Those of you who have been suffering from COPD for some

time have seen your recommended treatment change over the

years. Now, as a senior physician, I remember the days when

very little effective medication was available in inhaled form. IPPB

devices were common place and a real rational approach to the

medical treatment of COPD had to wait for decades until research

and the pharmaceutical industry provided a more rational

approach to daily treatment.

Today, most of the medications used to treat COPD are

inhaled using a device that can easily fit into your pocket or

purse. In fact, there has been an explosion of drugs and devices

over the last 10-15 years. Along with these medications has

come a new understanding about what we are trying to do for our

COPD patients and how we select the medications we use.

Initially, bronchodilators called LABAs were used alone.

These were long- acting medications designed to dilate the

airways. Later, steroids were added to these inhalers when it was

found that this combination could reduce the flare-ups, called

exacerbations, which plague the COPD patient. Finally, a

category of mediations called LAMAs were added to the mix and

these added another layer of protection for our COPD patients.

Today, for the moderate to severely affected patients all

three of these medications are being used. Each component has

its own risk and benefit and understanding how they benefit the

patient and how they should be used is the job of your doctor.