Chronic
Obstructive
Pulmonary
Disease
Patient
Information
Pack
Nina Turner-Respiratory Nurse Specialist
Nina.Turner@nhs.net
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What is COPD?
Chronic- means long standing (over 6months)
Obstructive- means block/narrowing (of airways)
Pulmonary- means lungs
COPD is a longstanding narrowing of the airways within the
lungs
COPD is an umbrella term for chronic bronchitis and
emphysema
What’s the difference between chronic bronchitis and
emphysema?
Emphysema is a breakdown of the airways- they lose their
elasticity and become floppy so air sacs in the lungs are
damaged and air becomes trapped.
Bronchitis is inflammation of the airways causing a chronic
cough, the production of sputum and a wheeze
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How do you get COPD?
Smoking is the leading cause of COPD and it is never too late to
quit as this will still improve your quality of life. Even if you
already have COPD this can add years to your life.
Some people develop COPD from exposure to air pollution,
dust or gases/fumes. Some may have a family history of it as it
can also be passed on through a rare gene.
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When do people get COPD?
The common age to start noticing symptoms can be from the
age of 35.
Is it serious?
The symptoms experienced depend on the severity of the
condition. If you have mild COPD you may have mild cough
that becomes worse in the winter or when you have a cold. In
more severe cases you may have breathing problems that limit
your normal activities. Remember that however badly a person
is affected; the right treatments will improve symptoms and
slow further disease progression.
How do I know if I have COPD?
 You may have the ongoing early morning ‘smokers
cough’
 Always get winter chest infections
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 Become short of breath more easily
 Need more pillows at night to keep upright as breathing is
difficult lying flat
 Wheezy chest
 Cough up sputum
 Tight feeling in chest
DO you answer yes to any of the above? If so put in an
application book to see GP/Nurse in healthcare for a check-up.
What should I do if I think I have COPD?
1. Try to quit smoking- you can put in an application to ask
for help from smoking cessation staff in healthcare
2. Put in an application to speak to the Doctor or a nurse in
healthcare so you can discuss your concerns.
How will COPD be diagnosed?
A full history will be taken from you by healthcare staff
A test called spirometry (shows how much air you can blow out
of your lungs and how quickly) will be preformed in the
healthcare department. This involves blowing into a machine
that provides results immediately and from these results you
may be referred onto the GP.
What happens if I have COPD and is there a cure?
There is not a cure for COPD. However, you can act quickly
when you have been diagnosed, to improve your quality of life
and slow down the progression of the disease.
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You need to quit smoking, this can add years to your life and
help to slow down the progression of the disease.
You will be started on medication and may need to have an xray and/or further tests; however, this is not always necessary.
You can learn about your condition and know when you need to
seek advice.
You may be prescribed inhalers and you will need to use them
regularly. If in doubt, seek advice from healthcare on how to
take your inhaler. This will ensure the full amount of medication
is taken and in turn help to stabilize your symptoms.
How can I help myself once I have COPD?
Take your medications properly and as prescribed.
Book your flu jab every year.
Have your pneumovac vaccine.
If you struggle with an inhaler ask the nurses to help you, if
necessary there are devices to help you take the inhaler called
spacers.
Continue to walk and exercise as much as you can, please ask
nurses if you are worried about how far you can push yourself
with exercise- ask about the pulmonary rehabilitation
programme.
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If you feel unwell because your COPD has got worse come to
healthcare ‘special sick’- recognize early symptoms of an
exacerbation (worsening of your breathing) and get prompt
treatment.
What is pulmonary rehabilitation?
Pulmonary rehab is a 6-8 week exercise programme run 2 days
a week. This is run by the healthcare and gym staff for patients
with COPD that fit the criteria. It involves 1 hour of exercise
and 1 hour of education. Patients are helped to increase their
exercise tolerance related to their breathlessness in turn have a
better quality of life. The education sessions are designed to
give you the knowledge and skills to help manage your lung
condition. Patients are rewarded with a certificate following
completion and encouraged to continue to exercise in the classes
provided by the gym.
When you are released from prison find out where the nearest
community respiratory team is. You can ask your GP or practice
nurse and ask to be referred. These teams are a great help and
will benefit you once you are outside.
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Sputum
If your sputum becomes very thick or increases in volume, it
means you need to drink plenty more fluids and may have an
infection if it is difficult to clear- come healthcare special sick if
concerned.
Yellow sputum can be ok as this contains neutrophils to fight
infection.
Green sputum, along with feeling more breathless, generally
unwell and tired are all reasons to come to healthcare to be
assessed.
Diet and fluids
If you have COPD you must drink plenty of fluids to loosen the
secretions on your chest.
You should try to eat well and regularly and if you are losing
weight inform healthcare. This is a symptom of COPD, as
breathing takes up lots of energy.
You should try to relax your shoulders when trying to breathe as
lifting them inhibits air flow and uses lots of energy leading to
further weight loss.
Enroll on the healthy living programme via the gym staff if
necessary.
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What are the inhalers for?
Inhalers are medications which are inhaled to relieve and/or
control your symptoms.
You will be given a blue inhaler which is called ventolin and/or
salbutamol this is a short acting bronchodilator, meaning it will
open the airways for a short period of time.
This inhaler should be with you at all times including any
external visits e.g court or hospital.
You may also be given a combination inhaler of steroids (to
reduce the inflammation) plus a long acting bronchdilator ( to
open airways in lungs for at least 12 hours).
How do I use an inhaler?
How to Use a Metered-Dose Inhaler "Puffer"?
A metered-dose inhaler, called an MDI for short, is a pressurized
inhaler that
delivers
medication
by using a
propellant
spray.
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To use an MDI:
1. Shake the inhaler well before use (3 or 4 shakes).
2. Remove the cap.
3. Breathe out, away from your inhaler.
4. Bring the inhaler to your mouth. Place it in your mouth
between your teeth and close you mouth around it.
5. Start to breathe in slowly. Press the top of you inhaler once
and keep breathing in slowly until you have taken a full
breath.
6. Remove the inhaler from your mouth, and hold your breath
for about 10 seconds, then breathe out.
If you need a second puff, wait 30 seconds, shake your inhaler
again and repeat steps 3-6. After you've used your MDI, rinse out
your mouth and record the number of doses taken.
Important reminders about MDIs: always follow the
instructions that come with your MDI.
 To clean your MDI, follow the instructions that came with it.
In most cases, they will advise you to:
 Keep your reliever MDI somewhere where you can get it
quickly if you need it.
 Show your doctor, pharmacist or asthma educator how you're
using your metered-dose inhaler.
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Store your MDI at room temperature. If it gets cold, warm it
using only your hands.
Never puncture or break the canister, or try to warm it using
anything except your hands.
When you begin using an MDI, write the start date on the
canister.
Check the expiry date on the MDI before you use it.
If you're having trouble using your MDI, ask your doctor for
tips or to recommend another device.
Many doctors recommend the use of a spacer, or a holding
device to be used with the MDI.
Do not float the canister in water.
If you find using this device difficult, there are devices to help
called spacers or you can change your inhaler if required-please
ask your healthcare team to help with this.
How do I use a spacer?
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To Use a Spacer:
1. Shake the inhaler well before use (3-4 shakes).
2. Remove the cap from your inhaler, and from your spacer, if it
has one.
3. Put the inhaler into the spacer.
4. Breathe out, away from the spacer.
5. Bring the spacer to your mouth, put the mouthpiece between
your teeth and close your lips around it.
6. Press the top of your inhaler once.
7. Breathe in and out very slowly 5 times. If you hear a whistle
sound, you are breathing in too fast.
Cleaning Your Spacer
To clean your spacer, follow the instructions that come with it. In
most cases, they will advise you to:
Take the spacer apart.
Gently move the parts back and forth in warm water using a mild
soap. Never use high-pressure or boiling hot water or disinfectant.
Rinse the parts well in clean water.
Do not dry inside of the spacer with a towel as it will cause static.
Instead, let the parts air dry (for example, leave them out
overnight).
Put the spacer back together.
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Important reminders about spacers
Only use your spacer with a pressurized inhaler, not with a drypowder inhaler.
Spray only one puff into a spacer at a time.
Use your spacer as soon as you've sprayed a puff into it.
Never let anyone else use your spacer.
Keep your spacer away from heat sources.
If your spacer has a valve that is damaged, or if any other part of
the spacer is damaged, do not use it. The spacer will have to be
replaced.
It is very important that you consult the healthcare department to
review proper inhaler technique.
How to Use a DISKUS®
A DISKUS® is a dry-powder inhaler that holds 60 doses. It
features a built-in counter, so that you always know how many
doses you have left in it.
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To use your DISKUS®:
1. Open your DISKUS®: Hold it in the palm of your hand, put
the thumb of your other hand on the thumb grip and push the
thumb grip until it "clicks" into place.
2. Slide the lever away from you as far as it will go to get your
medication ready.
3. Breathe out away from the device.
4. Place the mouthpiece gently in your mouth and close your
lips around it.
5. Breathe in deeply until you have taken a full breath
6. Remove the DISKUS® from your mouth.
7. Hold your breath for about ten seconds, then breathe out
8. Always check the number in the dose counter window to see
how many doses are left.
If you drop your DISKUS® or breathe into it after its dose has
been loaded, you may cause the dose to be lost. If either of these
things happens, reload the device before using it.
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How to Use a Turbuhaler®
A Turbuhaler® is a dry-powder inhaler available in an easy-to-use
format.
Some Turbuhalers® feature a dose counter that shows the exact
amount of medication left. If your Turbuhaler® doesn't have a
dose counter, then check for a red indicator in the windows on the
side of the device. When you see red in the window, there are
approximately 20 doses left and it's time to order a refill.
1. Unscrew the cap and take it off. Hold the inhaler upright.
2. Twist the coloured grip of your Turbuhaler® as far as it will go.
Then twist it all the way back. You have done it right when you
hear a "click".
3. Breathe out away from the device.
4. Put the mouthpiece between your teeth, and close your lips
around it. Breathe in slowly and deeply through your mouth.
5. Remove the Turbuhaler® from your mouth before breathing out
6. Always check the number in the side counter window under the
mouthpiece to see how many doses are left. For the Turbuhalers®
that do not have a dose counter window, check the window for a
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red mark, which means your medication is running out. When
finished, replace the cap.
If you drop your Turbuhaler® or breathe into it after its dose has
been loaded, you may cause the dose to be lost. If either of these
things happens, reload the device before using it.
Clean your Turbuhaler® as needed. To do this, first wipe the
mouthpiece with a dry tissue or cloth. Never wash the mouthpiece
or any other part of the Turbuhaler® - if it gets wet, it won't work
properly.
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How to use HandiHaler
4
1.
Open the HandiHaler device. Separate only one of the
blisters from the blister card; then open the blister.
2.
Insert the capsule and close the mouthpiece firmly against the
gray base until you hear a click.
3.
Press the green piercing button once until it is flat (flush)
against the base, then release. Just once.
4.
Breathe out completely. Then, with the HandiHaler in your
mouth, breathe in deeply until your lungs are full. You
should hear or feel the capsule vibrate (rattle). Remember,
to take your full daily dose, you must inhale twice from the
same SPIRIVA capsule.
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How to use Respimat
1. "Twist"
Hold the inhaler upright with the cap closed. Turn the transparent
base until it clicks.
2. "Press"
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Open the cap. Breathe out slowly, insert the mouthpiece, and point
the inhaler towards the back of the throat. While taking a deep
breath, press the dose-release button, and continue to breathe.
3. "Breathe"
Hold your breath for 10 seconds, or as long as it is comfortable,
and then breathe out slowly. Respimat® SMI - is simple to use, as
easy as breathing.
Keep the inhaler clean- wipe the mouthpiece inside and out once a
week with a damp cloth. Any slight discoloration of the
mouthpiece will not affect the performance of the inhaler
Do
not take the inhaler apart, or remove the transparent base, once the
cartridge has been inserted. Protect from freezing temperatures.
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How to use Eklira
To use your Genuair inhaler there are 2 steps you need to perform
after removing the cap:
Step 1 - Press and RELEASE the green
button and breathe out completely, away from the inhaler. Step 2 Place your lips tightly around the mouthpiece and inhale
STRONGLY and DEEPLY through the inhaler.
While you breathe in you will hear a “CLICK” which signals
that you are using the Genuair inhaler correctly.
• Keep breathing in even after you have heard the inhaler
“CLICK” to be sure you get the full dose.
• Remove the Genuair inhaler from your mouth and hold your
breath for as long as is comfortable, then breathe out slowly
through your nose
• Make sure the control window has turned to red. This confirms
that you have inhaled your full dose correctly. Inhaled
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correctly RED IF THE COLOURED CONTROL
WINDOW IS STILL GREEN, PLEASE REPEAT
INHALING STRONGLY AND DEEPLY THROUGH
THE MOUTHPIECE
• If the window still does not change to red, you may have
forgotten to release the green button before inhaling or may not
have inhaled correctly. If that happens, try again.
Make sure you have RELEASED the green button and take a
STRONG deep breath in through the mouthpiece.
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How to use Seebri
Only press button in once
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How to use Relvar
If you open and close the cover without inhaling the medicine,
you will lose the dose.
The lost dose will be securely held inside the inhaler, but it will no
longer be available. It is not possible to accidentally take extra
medicine or a double dose in one inhalation.
Prepare a dose-
wait to open the cover until you are ready to
take your dose. Do not shake the inhaler.
Slide the cover down until you hear a “click”.
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Your medicine is now ready to be inhaled. The dose counter counts
down by 1 to confirm.
If the dose counter does not count down as you hear the “click”,
the inhaler will not deliver medicine. Take it back to healthcare for
advice.
Do not breathe out into the inhaler
Do not block the air vent with your fingers.
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Take one long, steady, deep breath in. Hold this breath for as
long as possible (about 3-4 seconds).
Remove the inhaler from your mouth. • Breathe out slowly and
gently.
You may not be able to taste or feel the medicine, even when you
are using the inhaler correctly.
If you want to clean the mouthpiece, use a dry tissue, before you
close the cover.
Slide the cover upwards as far as it will go, to cover the
mouthpiece.
Rinse your mouth with water after you have used the
inhaler.
This will make it less likely that you will develop a sore
mouth or throat as side effects.
Some of the information and pictures for inhalers were taken directly from manufactures websites
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Managing my condition
What type of COPD I have & how long I have had this
(including my current symptoms):
My Medications and doses are:
Smoking status:
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Last exacerbation and treatment medications used:
My aims & goals in managing my condition:
What further help I may need to achieve my aims & goals:
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How I feel about my condition now:
My average diet and fluid daily and amount I do each day
e.g exercise/walking:
What actions I need to take:
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