‘World Chronic Obstructive Pulmonary Disease Day’… “Inhalers are ineffective if not used properly”

November 16 every year is World COPD Day. It was established in 2002 to raise awareness and interest in chronic obstructive pulmonary disease (COPD). The World Health Organization (WHO) announced the top 10 causes of death worldwide in 2020, placing chronic obstructive pulmonary disease as the third leading cause of death. By 2050, chronic obstructive pulmonary disease is expected to become the leading cause of death worldwide.

The situation in our country is not very different. It is a very common disease affecting 1 in 5 adults over 45 and 1 in 3 adults over 65 in Korea. However, due to lack of awareness of chronic obstructive pulmonary disease, most patients do not even know they are patients. In fact, according to the Health Insurance Review and Assessment Service, only 2.8% of those who admitted to being patients went to hospital after their symptoms worsened. If symptoms such as shortness of breath, phlegm, cough, chest discomfort, or fatigue persist, it is good to visit a hospital immediately and have a lung function test.

If COPD is diagnosed early and treated aggressively, the death rate can be significantly reduced. The following are the ‘7 Life Rules for Prevention and Management of Chronic Obstructive Pulmonary Disease (COPD)’ suggested by the Korean Centers for Disease Control and Prevention.

1. You must stop smoking
2. Get vaccinated against flu and pneumococcal
3. Avoid indoor and outdoor air pollution
4. Exercise regularly
5. Maintain an appropriate weight
6. COPD risk group receiving a pulmonary function test
7. Use prescribed medicines correctly

InhalantㅣSource: Getty Image Bank
Know how to use the inhaler correctly
In the case of chronic obstructive pulmonary disease treatment, most of them are prescription drugs, so they must be used after receiving a doctor’s prescription. In most cases, inhaled medications are used rather than oral medications. This is because it is effective and does not have many side effects. In the case of inhaled drugs, the dose of the drug is very small compared to oral drugs, and the effect does not appear if it is not used properly. Therefore, if you use it in the form of an inhaler, you should use it after thoroughly understanding the characteristics and uses of each type.

Portable inhalers used for chronic obstructive pulmonary disease are divided into ‘metered dose inhalers’ and ‘dry powder inhalers’ according to the inhalation container. It is important to exhale fully before using any inhaler, then inhale the drug and hold your breath for about 5 to 10 seconds. At this stage, as the drug is being rapidly injected into the body, the metered dose inhaler should exhale sufficiently before injecting, close the gap by biting the area around the inhaler, and inhale’ n deep when spraying. For dry powder inhalers, the drug is inhaled into the body by the patient’s breath, so inhale deeply after exhaling sufficiently, and do not exhale into the container.

Inhaler, even if side effects appear, the side effects disappear when the treatment ends
Inhalers are divided into ‘disease management agents’ which continuously manage symptoms such as breathlessness and prevent them from getting worse, and ‘symptom relievers’ which are emergency medicines which widen narrow airways in a short time. Disease management agents include beta 2 agonists and anticholinergics that widen the narrowed airway muscles, and inhaled corticosteroids that relieve inflammation in the lungs. Symptom relief includes short-acting beta 2 agonists and short-acting anticholinergics that rapidly improve symptoms such as dyspnea.

As a side effect of beta2 agonists, hand tremors may occur, and may occur more commonly with age. Hypokalaemia can also occur, more commonly when diuretics are used at the same time. A common side effect of anticholinergics is dry mouth. In addition, it can cause difficulty urinating or increase intraocular pressure, so glaucoma patients should be careful. Short-acting anticholinergics may complain of a bitter or metallic taste. Side effects of inhaled steroids include fungal infections of the mouth, hoarseness, and an increased risk of pneumonia.

SmokingㅣSource: Getty Image BankSmokingㅣSource: Getty Image Bank
80% of COPD is related to smoking
Tobacco smoke and tobacco components are harmful substances including carcinogens, and 80% of chronic obstructive pulmonary disease patients are caused by smoking. Therefore, smoking cessation is the surest way to prevent the occurrence of COPD, prevent disease progression and acute exacerbations, and reduce mortality.

Combining drug treatment and counseling increases the success rate of attempts to quit smoking, so it is good to consult a specialist for help. Counseling is known to be more effective the more times you practice it. Visit the smoking cessation clinic of each local public health center or hospital, call the smoking cessation helpline (☎1544-9030), or visit the internet website of the smoking cessation guide (http://www.nosmokeguide.or.kr) and other services available.

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