James Paget University Hospitals NHS Foundation Trust Great Yarmouth and Waveney Clinical Commissioning Group HealthEast Chronic Obstructive Pulmonary Disease (COPD) Information and Advice for Patients This booklet contains information about the medication used for treatment of your condition and an action plan to use if your condition gets worse due to an infection. Please bring this document with you when you see your doctor or nurse about your COPD.
Information about your medication Inhalers Bronchodilators These relax the muscles in your airways and make it easier for you to breathe. Short-acting Bronchodilators start to work within about 10 minutes and the effect should last for about four hours. Your short-acting medication is:... Bronchodilators that are long-acting take more time before they have an effect but last 12-24 hours. Your long-acting medication is:... Inhaled steroids These are sometimes used to reduce inflammation in your lungs. They are usually taken twice a day and will not take effect immediately. You should rinse your mouth after taking these to prevent thrush. Your inhaled steroid medication is:... Combination inhalers Some inhalers contain both an inhaled steroid and a long-acting bronchodilator. These are usually taken twice a day. You should rinse your mouth after taking these to prevent thrush. Your combination inhaler is:... Other medication Tablets or capsules may be prescribed. These are to be taken regularly to help your breathing or reduce the amount of phlegm you produce. 2
Your usual treatment (To be taken when your condition is stable) Regular medication Name Dose Morning Lunch Evening Bedtime Medication to be taken, when necessary Name Instructions Important Note: Make sure you do not run out of your medication. When you ask for a repeat prescription from your surgery, always allow time (usually two days) for them to arrange it. 3
COPD Action Plan When you are well, be aware of the following: How much activity you can do each day. What your breathing is like when you are resting and when you are active. How much phlegm you cough up and what colour it is. Things that make your breathing worse. What your appetite is like. How well you are sleeping. The following are signs that your symptoms are getting worse: More breathless or wheezy than usual. Reduced energy for daily activities. Coughing up more phlegm. Change in colour of phlegm. Poor sleep and/or symptoms waking you in the night. The following are signs of a severe attack: Breathlessness and cough getting worse. You are not able to carry out your normal daily activities. Your medications are not working. The following are danger signs: Very short of breath at rest with no relief from medication. Chest pains. High fever. A feeling of agitation, fear, drowsiness or confusion. 4
Action: Have something to look forward to each day. Plan ahead pace yourself and allow enough time to do things. Exercise every day. Eat a balanced diet and drink plenty of fluids. Avoid things that make your condition worse. Take your medication as directed by your doctor. Never allow your medications to run out. Action: Contact your doctor or community nurse if you need to talk about increasing your reliever medication and starting antibiotics and/or steroids (SOS pack) see next page. Allow more time for things. Get plenty of rest. Use relaxation and controlled breathing techniques. Eat small amounts more often and drink enough fluids. Action: Phone your doctor for an urgent appointment or home visit. Action: Dial 999 for an ambulance or ring the emergency doctor. 5
SOS Medication to use when your symptoms are worse Be aware of signs that your breathing or cough is getting worse and use the colour-coded action plan (see middle pages). Take immediate steps to increase your treatment and take additional medication as this may reduce the risks of your breathing becoming worse. Your GP may allow you to have reserve antibiotics and steroids at home to use if your symptoms become worse. Check the medication expiry dates regularly. If you are in any doubt about what to do, contact your GP or community nurse, or their Out of Hours service for advice. Extra reliever - to reduce breathlessness Take up to puffs of every hours. Use aerosol inhalers through a spacer for maximum effect. Antibiotic - to use if your sputum becomes coloured or the amount increases due to infection Take..mg. times a day for seven days. Prednisolone (steroid) tablets to use to reduce inflammation in the lungs when your breathing is bad Take six, 5mg tablets as a single dose, once a day for seven days. 6
Things you can do to keep well Avoid places where other people are smoking. Stop smoking - it is never too late for this to be beneficial. Try to exercise every day, e.g. walk for ten minutes three times a day - you will not cause yourself any harm by becoming slightly short of breath when exercising. Maintain a healthy body weight and eat a balanced diet. Avoid sedatives or too much alcohol. Make sure you know how to use your inhalers properly. Your nurse will be able to give you advice on this. Have a flu vaccination every year. Have a pneumococcal vaccination (this only needs to be done once). In very cold weather, make sure you have enough heating indoors. If you need to go out, wear warm clothing and make sure you carry your reliever inhaler with you. Find out about the local pulmonary rehabilitation from your GP or community nurse. 7
Name GP: Practice: Consultant: Respiratory nurse: Hospital: Contact tel no: Contact tel no: Lung Function Measurements - to be completed by the doctor or nurse. Date FEV1 FVC Sa02 The hospital is able to arrange for an interpreter to assist you in communicating effectively with staff during your stay through INTRAN. If you need an interpreter or a person to sign, please let us know. If you require a large print version of this booklet, please contact PALS on 01493 453240 This leaflet has been reproduced with permission of the Community Respiratory Service, Central Norfolk NHS. December 2007 Revised: March 2011, December 2011, March 2013 Review Date: March 2016 James Paget University Hospitals NHS Foundation Trust HE 6a version 3