People with chronic obstructive pulmonary disease (COPD) may occasionally have symptom exacerbations, or flare-ups. Treatments options for exacerbations include bronchodilators, corticosteroids, antibiotics, oxygen therapy, and ventilation.

COPD is the name given to a group of long-term lung diseases. The condition tends to get worse over time and symptoms can include:

  • wheezing
  • shortness of breath
  • coughing
  • excess mucus production
  • chest tightness
  • fatigue

People with COPD may occasionally notice that their symptoms suddenly get worse, or that new symptoms develop. Doctors refer to these periods as exacerbations, or flare-ups.

In some people, certain things, such as an infection, a change in the weather, or exposure to irritants or allergens, can trigger an exacerbation.

In this article, learn about some of the options for treating a COPD exacerbation. We also discuss the importance of treating exacerbations, when hospitalization may be necessary, and some tips for preventing exacerbations.

Generally, the sooner a person begins treatment for a COPD exacerbation, the better. Several treatment options are available, including:


Man holding a bronchodilator for copd exacerbation treatmentShare on Pinterest
A bronchodilator can open the lungs to ease the symptoms of a COPD exacerbation.

Bronchodilators are medications that relax the muscles of the airways, which helps them open up. One of the most common bronchodilators that doctors prescribe for people with COPD is albuterol.

A COPD exacerbation may result in increased chest tightness, wheezing, or shortness of breath. Taking medication to open the lungs, such as a bronchodilator, can help ease these symptoms.

Bronchodilators typically come in the form of an inhaler device or a liquid. To take the liquid form, a person must use a machine called a nebulizer to turn the liquid into an aerosol or mist, which a person can then inhale into the lungs.

Side effects of using a bronchodilator may include a faster heart rate, a headache, and shakiness.


Increased inflammation of the lungs and airways can trigger a COPD exacerbation. Corticosteroids can help reduce this inflammation and relieve symptoms.

Corticosteroids come in many forms, including tablets, inhaler devices, and injections. Corticosteroids that doctors commonly prescribe for the treatment of COPD exacerbations include prednisone and budesonide.

Corticosteroids can cause systemic side effects, especially when a person takes them intravenously or orally. Systemic side effects can affect the whole body.

Possible side effects include increased blood sugar, nervousness, and headache. Nebulized corticosteroids may cause hoarseness, dry mouth, or oral yeast infections.

The best way to administer corticosteroids to treat a COPD exacerbation depends on the type and severity of symptoms. However, the results of a 2014 study suggest that nebulized corticosteroids may be as effective as intravenous corticosteroids but with fewer systemic side effects.


People with COPD are more likely to develop a lung infection than those without the lung disease. These infections can lead to an exacerbation, and people with COPD may be more likely to experience complications from lung infections.

If a doctor suspects that a person with COPD has a bacterial infection, they may prescribe them a course of antibiotics.

The results of a 2013 study that involved 53,900 participants suggest that adding antibiotics to a treatment plan that also included corticosteroids may briefly improve symptoms for people in the hospital with a COPD exacerbation.

Oxygen therapy

A person’s oxygen levels may decrease during a COPD exacerbation. Oxygen therapy can help improve oxygen levels in the blood and ease the related symptoms, such as shortness of breath.

During oxygen therapy, a person will inhale oxygen from a machine through a mask or via nasal tubes. People can use an oxygen therapy machine at home.

Noninvasive ventilation

A woman using a Noninvasive ventilation machine <br />Image credit: James Heilman, 2014 </br>“><br><em>People with severe COPD exacerbation may need treatment with noninvasive ventilation.<br>Image credit: James Heilman, 2014 </em></div>
<p>Noninvasive ventilation (NIV) is a type of respiratory support that can improve oxygen levels, inflate the lungs, and make breathing easier. NIV involves a machine that delivers pressure and oxygen to the lungs through a mask.</p>
<p>Doctors will typically provide NIV to people in the hospital with a severe COPD exacerbation.</p>
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Quitting smoking can help prevent COPD exacerbations.