The Best COPD Exacerbation Treatments: How to Breathe Easier During a Flare-up

Chronic obstructive pulmonary disease (COPD), a condition that affects more than 14 million U.S. adults, is marked by damage to the airways. It typically refers to emphysema and chronic bronchitis. Not only does labored breathing make everyday tasks more difficult, it can also lead to severe health risks when symptoms worsen over a short period—something known as a COPD exacerbation that requires treatment.

“COPD exacerbations are defined by worsening symptoms like shortness of breath, a more frequent or intense cough and changes in mucus production that develop over a couple of weeks,” says pulmonologist Jamie Garfield, MD, a professor of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine at Temple University. 

These episodes are often triggered by respiratory viral infections and environmental irritants like wildfire smoke or air pollution that hamper lung function.

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COPD exacerbations can be serious 

“The five-year mortality rate for people who are hospitalized with severe COPD exacerbations is around 50 percent,” she explains. It is the fourth leading cause of death in the U.S. Fortunately, acting quickly when symptoms worsen can significantly reduce the risk of serious complications. 

“The sooner you recognize changes—whether it’s needing your bronchodilator more often, feeling more fatigued or struggling to breathe—the better your chances of staying out of the hospital,” she adds.

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How to recognize a COPD exacerbation

A COPD exacerbation doesn’t just mean you’re having a “bad day”—it’s a sign that inflammation or infection in the lungs is worsening. Symptoms often include increased shortness of breath during routine activities, a more frequent cough producing thick or discolored mucus and unusual fatigue.

“Changes in mucus, like it getting thicker or turning yellow or green, are often one of the first clues that something is going on,” says Dr. Garfield. Other signs of exacerbations of chronic obstructive pulmonary disease include chest tightness or discomfort and wheezing while breathing.

How to prevent COPD exacerbations

The best form of COPD exacerbation treatment is preventing a flare-up altogether. And while some triggers can’t be avoided, many can be minimized with simple strategies.

Don’t skip your flu shot

Respiratory infections are a leading cause of exacerbations. “Vaccinations are incredibly effective at reducing the likelihood of COPD exacerbations,” says Dr. Garfield. “Flu, pneumococcal, COVID-19 and RSV vaccines are especially important for people with COPD.” 

Talk to your doctor about setting up a schedule for vaccinations. Some, like the flu and COVID shot, can be done in the same visit to your doctor or pharmacy clinic. 

Switch on an air purifier

Triggers like wildfire smoke, poor air quality and fumes can irritate already vulnerable lungs and worsen COPD symptoms. “If you’re in an environment with poor air quality, staying indoors or wearing a mask can reduce your exposure,” Dr. Garfield says. Also smart? Using an air purifier with a HEPA filter, such as Coway Airmega 100.

As for irritants you can control, avoid fireplace smoke or poorly-ventilated cooking spaces, and be sure to quit smoking (and steer clear of secondhand smoke) to safeguard your lungs. Learn how to kick the habit here.

Take a relaxed walk

Pulmonary rehabilitation, including breathing exercises, strengthens the muscles involved in breathing. This makes it easier to handle COPD exacerbations. Even regular walks or light exercises can enhance resilience, lower the risk of flare-ups and improve your overall quality of life in the long term, Dr. Garfield says.

Wash your hands

We know you know this, but it’s extra important to protect yourself from infections when you’re dealing with COPD. Simple steps like washing your hands frequently, wearing a mask in crowded places and avoiding close contact with people who are ill go a long way toward warding off COPD exacerbations. 

Tip: Spending time around children with colds, like your grandkids? “Make sure you’re washing your hands and taking precautions to protect yourself,” Dr. Garfield adds.

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COPD exacerbation treatment

If you experience a COPD exacerbation, starting treatment fast is important. When symptoms worsen, bronchodilators—medications that relax the muscles in your lungs and open your airways—are the first line of defense. For more severe cases, oral corticosteroids such as prednisone are often prescribed. “These are the mainstays of treatment when symptoms worsen,” says Dr. Garfield.

Here’s what else can help:

• Check your oxygen saturation. Some COPD patients monitor their oxygen saturation at home using a pulse oximeter, a small device that painlessly clips onto your finger, toe or earlobe to measure oxygen saturation. A healthy oxygen level is 95 percent or higher. “If there is a change in oxygen saturation, that might be an indication that there’s something going on requiring more attention,” Dr. Garfield notes.
• Take it easy. Rest and hydration are also crucial during a COPD exacerbation. Hydration thins mucus (which helps prevent airway obstruction), while rest helps the body recover.
• Avoid irritants. During a flare-up, avoid irritants by staying indoors on high-pollution days or using a mask and air filters, advises Dr. Garfield. 

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In severe cases, surgery may help improve symptoms. Procedures such as lung volume reduction surgery, which removes damaged lung tissue, or a lung transplant can enhance breathing. 

When to seek help for COPD exacerbation treatment

While most COPD exacerbations can be managed at home with the help of your doctor, knowing when to seek medical attention is crucial. “If you’re feeling chest pain, pressure, you’re coughing up mucus that has really changed in color or quantity or consistency, these would be indications to seek medical attention,” Dr. Garfield says. “You may not need to go to the hospital, but it’s certainly a reason to get in contact with your doctor.”

Recognizing symptoms early and seeking timely care can make all the difference. With the right treatment and lifestyle adjustments, living well with COPD is possible.