How Do COPD Agents Work?

COPD agents are medications prescribed to treat chronic obstructive pulmonary disease (COPD) and asthma. Several classes of medications are used as COPD agents, which work in unique ways to dilate the bronchial passage and ease breathing.

COPD agents work in the following ways:

• Relax bronchial smooth muscles
• Inhibit hypersensitive reactions in the bronchial passage
• Reduce mucus secretion in the respiratory system
• Improve lung function

COPD agents are primarily combinations of the following medications:

• Long-acting beta2 agonists (LABAs): LABAs enhance the activity of beta-2 adrenergic receptors, protein molecules on cell surfaces that are stimulated by epinephrine, a natural hormone in the body. LABAs relax bronchial muscles and inhibit hypersensitivity reactions from mast cells, a type of immune cells that initiate allergic reactions.
• Long-acting muscarinic antagonists (LAMAs): LAMAs block the activity of muscarinic receptors which make muscles contract in response to acetylcholine, a chemical that nerve endings secrete. LAMAs relax bronchial smooth muscles, reduce mucus secretion in the respiratory system and improve lung function.
• Corticosteroids: Corticosteroids are potent anti-inflammatory agents that prevent immune cells from releasing pro-inflammatory substances. Corticosteroids have an effect on many types of immune cells such as mast cells, eosinophils, basophils, lymphocytes, macrophages, and neutrophils.

COPD agents are administered as oral inhalations in the form of powders, aerosolized tiny particles or droplets, or solutions nebulized into a fine mist. Many types of inhalation devices such as metered dose inhalers and nebulizers are available on prescription.

COPD agents are used in the treatment of the following conditions:

FDA-approved:

• Long term maintenance treatment of chronic obstructive pulmonary diseases including:
  • Chronic bronchitis
  • Emphysema
• Prevention and maintenance treatment of asthma, an inflammatory bronchial condition

Orphan designation:

• Treatment of symptomatic exophthalmos (bulging of eyes) associated with thyroid-related eye disease

Side effects of COPD agents may include the following:

• Upper respiratory tract infection
• Headache
• Pharyngitis (throat inflammation)
• Nasopharyngitis (inflammation of nose and throat)
• Throat irritation
• Bronchitis (inflammation of bronchial passage)
• Upper respiratory inflammation
• Viral respiratory infections
• Candidiasis, nonspecific site
• Cough
• Sinusitis (inflammation of the sinuses)
• Dysphonia (hoarseness)
• Oropharyngeal pain (mouth and throat pain)
• Respiratory congestion and tightness
• Dyspnea (shortness of breath)
• Wheezing
• Immediate and paradoxical bronchospasm
• Tracheitis (bacterial infection of the trachea)
• Pneumonia
• Fever
• Nausea
• Vomiting
• Diarrhea
• Gastrointestinal (GI) discomfort or pain
• Dyspepsia (indigestion)
• Viral GI infections
• Urinary tract infection
• Urinary retention
• Oral candidiasis
• Tooth abscess
• Xerostomia (dry mouth)
• Musculoskeletal pain
• Muscle cramps or spasms
• Myositis (muscle inflammation)
• Malaise or fatigue
• Arthralgia (joint pain)
• Osteoporosis (bone loss)
• Chest pain
• Back pain
• Pain in extremities
• Influenza
• Dizziness
• Fall
• Contusion
• Palpitations
• Angina pectoris (chest pain due to coronary heart disease)
• Tachycardia (rapid heart rate)
• Cardiac arrhythmias (irregular heartbeats) such as:
  • Ventricular tachycardia (rapid heart rate beginning in the ventricles-lower chambers of the heart)
  • Supraventricular tachycardia (rapid heart rate beginning above the ventricles)
  • Ventricular extrasystoles (extra heartbeats)
  • Atrial fibrillation (irregular and rapid heart rate with the atria out of synchronization with the ventricles)
• Cushing syndrome/hyperadrenocorticism (a condition caused by high cortisol levels from prolonged corticosteroid use)
• Cushingoid features (facial roundness and fat accumulation in midsection and upper back due to Cushing syndrome)
• Growth velocity reduction in children and adolescents
• Glaucoma (an eye condition that damages the optic nerve)
• Cataracts
• Blurred vision
• Central serous chorioretinopathy (fluid buildup under the retina which can lead to retinal detachment and vision loss)
• Hypersensitivity reactions
• Ecchymosis (bruising)
• Photodermatitis (light-sensitive dermatitis)
• Facial and oropharyngeal edema
• Anaphylactic reaction in people with severe milk protein allergy (very rare)
• Pallor
• Hyperglycemia (high blood glucose levels)
• Weight gain
• Paresthesia (skin prickling sensation)
• Restlessness
• Tremor
• Anxiety
• Nervousness
• Agitation
• Aggression
• Depression
• Abnormal behavior
• Sleep disturbance
• Insomnia
• Behavioral changes such as hyperactivity and irritability primarily in children (rare)
• Dysmenorrhea (painful menstruation)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of COPD agents include:

• Advair Diskus
• Advair HFA
• AirDuo Digihaler
• AirDuo RespiClick
• Bevespi Aerosphere
• Breztri
• budesonide/formoterol/glycopyrrolate inhaled
• glycopyrrolate inhaled
• glycopyrrolate inhaled/formoterol
• Lonhala Magnair
• salmeterol/fluticasone inhaled
• Wixela Inhub