What is copd flare-up?

Chronic obstructive pulmonary disease (COPD) is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.

Chronic bronchitis and emphysema are two lung problems that are types of COPD:

• Chronic bronchitis: The airways that carry air to the lungs (bronchial tubes) get inflamed and make a lot of mucus. This can narrow or block the airways. It can also make you cough.
• Emphysema: The tiny air sacs (alveoli) at the end of the airways in the lungs are damaged. When the air sacs are damaged or destroyed, the inner walls break down, and the sacs become larger. These larger air sacs move less oxygen into the blood. This causes difficulty breathing or shortness of breath that gets worse over time. After air sacs are destroyed, they cannot be replaced.

Many people with COPD have attacks called flare-ups or exacerbations. This is when your usual symptoms quickly get worse and stay worse.

If you notice any problems or new symptoms, get medical treatment right away.

When you have a COPD flare-up, your lungs may suddenly produce more mucus. Or the airways of your lungs (bronchial tubes) may suddenly get narrower. These two things reduce the airflow in your lungs. That makes it harder to breathe and makes your coughing worse.

In a COPD attack or flare-up, your usual symptoms suddenly get worse. You have more shortness of breath and wheezing. You have more coughing, with or without mucus. You may cough up more mucus than usual, and it may be a different color.

Treatment of a COPD flare-up, or attack, depends on how bad the flare-up is. Mild flare-ups may be treated by following your doctor's instructions for using a quick-relief (short-acting) inhaler or oral steroid medicines. More severe flare-ups may involve visits to your doctor's office or clinic. Or you may need to be treated in the hospital. Treatments include:

• Quick-relief inhaled bronchodilators. These medicines relax the bronchial tubes and make it easier to breathe.
• Oral steroid medicines. They reduce the swelling in your airways.
• A machine to help you breathe better or to breathe for you. These are called ventilation machines.
• Oxygen, to increase the amount of oxygen in your blood.

Treatment may also include:

• Intravenous (I.V.) fluids to treat dehydration.
• Other bronchodilators.
• Antibiotics. Your doctor may prescribe antibiotics to help treat a bacterial infection.

Your doctor will ask about your symptoms and past health and will do a physical exam. You may have blood tests, a chest X-ray, and tests to check oxygen levels in your blood, such as pulse oximetry. You may have more testing to check for other health problems.

Medicines called bronchodilators are used to open or relax your airways and help your shortness of breath. These medicines are usually given through an inhaler. They can help prevent COPD flare-ups or to keep them from becoming life-threatening.

A metered-dose inhaler is one type of inhaler. It gives a measured dose of medicine in the form of a liquid mist. This lets you breathe medicine into your lungs quickly. Inhaled medicine works faster than the same medicine in a pill. An inhaler allows you to take less medicine than you would need if you took it as a pill.

Using a spacer with a metered-dose inhaler is the best way to get the most medicine to your lungs. A spacer is a chamber that you attach to the inhaler. The chamber holds the medicine before you inhale it. That way, you can inhale the medicine in as many breaths as you need.

Get the most from your inhaler

Many people don't use their inhalers the right way, so they don't get the right amount of medicine. Talk with your doctor to be sure you are using each type of inhaler the right way. It might help if you practice using it in front of a mirror.

• Use your inhalers exactly as prescribed.
• Check that you have the correct medicine. If you use several inhalers, put a label on each one so that you know which one to use at the right time.
• Keep track of how much medicine is in the inhaler. Check the label to see how many doses are in the container. If you know how many puffs you can take, you can replace the inhaler before you run out. Learn how to estimate how much medicine is left. Your doctor or pharmacist can help you with this.
• A spacer is recommended for most metered-dose inhalers, especially those with corticosteroid medicines.

• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You may be taking medicines such as:
  • Bronchodilators. These help open your airways and make breathing easier.
  • Corticosteroids. These reduce airway inflammation. They may be given as pills, in a vein, or in an inhaled form. You may go home with pills in addition to an inhaler that you already use.
• A spacer may help you get more inhaled medicine to your lungs. Ask your doctor or pharmacist if a spacer is right for you. If it is, ask how to use it properly.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If your doctor prescribed oxygen, use the flow rate your doctor has recommended. Do not change it without talking to your doctor first.
• Do not smoke. Smoking makes COPD worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

The two most common causes of a COPD flare-up, or attack, are respiratory tract infections, such as acute bronchitis or pneumonia, and air pollution. Having other health problems, such as heart failure or an abnormal heartbeat (arrhythmia) may also trigger a flare-up. In some cases, the cause is not known.

When your COPD symptoms get worse suddenly and stay bad, it's called a flare-up. Your cough and mucus get worse, and it may be harder to breathe. A flare-up can be dangerous, so it's important to know what to do and take action. Your doctor can help you make a plan to manage flare-ups.