Watch Out for the Signs of COPD Exacerbations

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Watch Out for the Signs of COPD Exacerbations
While chronic obstructive pulmonary disease (COPD) cannot be cured, or the lung damage reversed, it can be managed, and the progression of COPD slowed. The objective is to keep the disease under control by limiting the number of acute episodes—known as COPD exacerbations or flare-ups—when symptoms become suddenly worse and may persist for days or longer.

Because COPD exacerbations reduce the quality of life, may be fatal (especially in later stages of COPD), and may lower long-term survival rates, you need to use medications, lifestyle changes and therapeutic treatments to:

1.) Manage your disease and prevent as many COPD flare-ups as possible

2.) Relieve the symptoms of an exacerbation as quickly as possible

As a 2010 article by Ann E. Evensen, MD, in American Family Physician, explains: “Exacerbations of chronic obstructive pulmonary disease contribute to the high mortality rate associated with the disease. Randomized controlled trials have demonstrated the effectiveness of multiple interventions.”1

In other words, it is critical that you watch out for the signs of COPD exacerbations.

Causes of COPD Exacerbations

Many different conditions can cause flare-ups. Learn to recognize those conditions that are most likely to trigger your flare-ups which include:

  • Air pollution—from traffic, industry or cigarette smoke
  • Environmental irritants—such as pollen and dust
  • Respiratory tract infections
  • Extreme temperatures and higher altitudes

Symptoms of COPD Exacerbations

Be aware of the symptoms of your COPD and any sudden changes. By recognizing the symptoms of a COPD exacerbation early, you can administer rescue medications quickly and possibly reduce the duration and severity of a flare-up. Symptoms include:

  • Sudden shortness of breath
  • Wheezing
  • Increased coughing
  • Production of more mucus than usual

Medications for COPD Exacerbations

Medications fall into two basic categories:

  • Controller medications—long-term preventive treatment to help keep you from having a serious breathing problem
  • Rescue medications—short-term, fast-acting treatment to provide immediate relief Nawhen you feel the symptoms of a COPD exacerbation coming on

Therapeutic Treatments for COPD Exacerbations

In addition to the medications that control and relieve the symptoms of COPD, several treatments and medicines help to prevent or relieve conditions that may trigger a flare-up:

  • Oxygen treatment to increase the levels of oxygen in the blood2
  • Antibiotics for bacterial infections that may exacerbate COPD conditions3
  • Diuretics to help remove water from body tissues when congestive heart failure co-exists with COPD and puts additional stress on heart and lungs4
  • Flu and pneumonia vaccines to help prevent respiratory complications that may result in hospitalization5

Preventing and Predicting Future COPD Exacerbations

Most of the focus has been on preventing flare-ups by effectively managing your COPD. These include:

  • Lifestyle changes, such as quitting smoking
  • Vaccinations for flu and pneumonia
  • Long-term oxygen therapy
  • Controller medications, such as long-acting bronchodilators and inhaled corticosteroids

More recently, however, researchers have been exploring techniques to predict COPD exacerbations better. If you can identify signs that predict a flare-up in the near future, it may be possible to make adjustments in treatment and medications that will prevent an acute episode.

One of the more noteworthy discoveries in predictive research is the correlation between increased levels of certain proteins in the blood and flare-ups. A study of more than 61,000 people in Denmark found that infections, inflammation and tissue damage result in increased levels of C-reactive protein, fibrinogen and leukocytes, which may make these proteins useful markers for helping to predict flare-ups.6

Additional research will need to be done to determine whether using these markers to prescribe a change in medication to lower inflammation and treat infections also prevents future exacerbations.

In the meantime, if you know the signs of a COPD exacerbation, stay alert to them, and follow your doctor’s directions with medications and treatments, you may be able to improve your quality of life. Also, make lifestyle changes, such as stopping smoking, as soon as possible to improve your prognosis.


Ann E. Evensen, “Management of COPD Exacerbations,” American Family Physician, http://www.aafp.org/afp/2010/0301/p607.html#afp20100301p607-b14 (March 2010).2 COPD Foundation. Oxygen Therapy. http://www.copdfoundation.org/What-is-COPD/Living-with-COPD/Oxygen-Therapy.aspx. Accessed 7.23.16.

3 National Jewish Health. Antibiotics for COPD. https://www.nationaljewish.org/healthinfo/medications/copd/antibiotics. Accessed 7.23.16.

4 MentalHelp.Net. COPD Treatment. https://www.mentalhelp.net/articles/copd-treatment/. Accessed 7.23.16.

5 Healthline. COPD and Pneumonia: Understanding Your Risk. http://www.healthline.com/health/copd/copd-and-pneumonia-understanding-your-risk. Accessed 7.23.16.

6 M. Thomsen et al, “Inflammatory Biomarkers and Exacerbations in Chronic Obstructive Pulmonary Disease,” JAMA, http://www.ncbi.nlm.nih.gov/pubmed/23757083 (June 2013).