When I ask patients what their inhalers do, they almost always respond by saying, “They open up my lungs.” Yes, that’s true. But what’s really important to know - and understand – about COPD medications is that there are different types of medications that open the airways in different ways. This might sound kind of complicated but it’s not all that hard to understand if we break it down into pieces.

This is Part I of a four-part series on Understanding and Using Your COPD Medications.

In Part I:
•    The difference between two main types of inhalers: Controllers   (maintenance/preventers) and relievers (rescuers)
•    Inhaled corticosteroids
•    Short (fast)-acting bronchodilators

In Part II:
•    Long-acting bronchodilators
•    Combination inhalers
•    Anticholinergics
•    Oral medications (pills you swallow)
•    Side effects of COPD medications

In Part III:
•    MDIs (Metered Dose Inhalers) technique
•    Spacers and Holding Chambers
•    How to tell how many doses are left in your MDI

In Part IV:
•    DPIs (Dry Powder Inhalers)
•    Nebulizers
•    Timing and sequencing of inhaled medicines


To get the most out of this article, I recommend you print it out, circle the names of the medicines your doctor has prescribed for you (even if you don’t take them everyday), and highlight the categories they are in. This will help you understand how each of these breathing medicines are supposed to work in your lungs so you can and take them with maximum effectiveness. Feel free to take the list to your next appointment and discuss this with your lung health care professional.

Fire Prevention and Calling 911
There are two different, very basic ways that medications act to open up the airways in your lungs: They act as Controllers (maintenance or preventers) or Relievers (rescue). For the sake of this discussion, we’ll refer them as either Controllers or Relievers. An easy way to understand how these medications work is to look at this in the same way we look at fire.

Controllers (Maintenance-Prevention): As a responsible person, you do your best to prevent fires by maintaining your home, keeping the electrical wires operating safely, turning off the stove when you’re not using it, and putting hot matches in a ceramic dish or in water. All these things help you control your environment by preventing a fire from starting. If you’re not careful, what might happen? A fire could start, and even if it starts small, it could quickly become a raging inferno. As we all know, it makes a lot more sense to prevent a fire than allow one to start!

Relievers (Rescue):  If and when a fire does start, however, you have (or should have) a fire extinguisher handy. And we also have the 911-system to call for help. But, again, if you can prevent a fire from starting – even knowing all the while that you have help to put it out – you should do it.