What are the best practices for maintaining lung health and managing lung conditions such as Chronic Obstructive Pulmonary Disease (COPD) and asthma?

From the Guidelines

Maintaining optimal lung health and managing conditions like COPD and asthma requires a comprehensive approach combining lifestyle modifications, medication adherence, and environmental awareness, with pulmonary rehabilitation being a key component, as recommended by the American Thoracic Society in 2023 1. The most effective strategy for managing lung health involves a multifaceted approach that includes:

• Quitting smoking immediately, with options like nicotine replacement therapy or medications such as varenicline (Chantix) or bupropion (Zyban) to aid in cessation
• For COPD management, using bronchodilators like albuterol, long-acting medications such as tiotropium (Spiriva) or salmeterol/fluticasone (Advair), and considering pulmonary rehabilitation, especially for adults with stable COPD, as it is strongly recommended by the American Thoracic Society 1
• For asthma, utilizing controller medications like inhaled corticosteroids and rescue inhalers like albuterol for symptom relief
• Regular exercise to improve lung capacity, aiming for 30 minutes of moderate activity most days
• Maintaining good indoor air quality through the use of HEPA air purifiers, avoiding harsh chemicals, and keeping humidity between 30-50%
• Annual influenza vaccination and pneumococcal vaccination as recommended
• Practicing breathing exercises such as pursed-lip breathing and diaphragmatic breathing to strengthen respiratory muscles These approaches are supported by recent guidelines, including the 2023 Canadian Thoracic Society guideline on pharmacotherapy in patients with stable COPD, which emphasizes the importance of personalized management plans and comprehensive approaches to improve symptoms, health status, and prevent exacerbations 1. Additionally, the Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 report highlights the effectiveness of pharmacologic therapy, pulmonary rehabilitation, and other interventions in managing COPD 1.

Key considerations in managing lung health include:

• The importance of pulmonary rehabilitation, as highlighted by the American Thoracic Society in 2023, which recommends participation in pulmonary rehabilitation for adults with stable COPD and other chronic respiratory diseases 1
• The need for personalized management plans that take into account the individual's symptom burden, health status, and risk of exacerbations, as emphasized by the Canadian Thoracic Society guideline 1
• The role of nonpharmacologic interventions, such as smoking cessation counseling, vaccinations, self-management education, and pulmonary rehabilitation, in comprehensive COPD management, as noted in the 2023 Canadian Thoracic Society guideline 1
• The importance of regular assessment and monitoring to adjust treatment plans as needed and to prevent exacerbations, as recommended by the Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 report 1.

From the FDA Drug Label

Fluticasone propionate and salmeterol inhalation powder is indicated for the twice-daily treatment of asthma in patients aged 4 years and older Fluticasone propionate and salmeterol inhalation powder 250 mcg/50 mcg is indicated for the twice-daily maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema Fluticasone propionate and salmeterol inhalation powder should be administered as 1 inhalation twice daily by the orally inhaled route only Patients using fluticasone propionate and salmeterol inhalation powder should not use additional LABA for any reason

The best practices for maintaining lung health and managing lung conditions such as Chronic Obstructive Pulmonary Disease (COPD) and asthma include:

• Using fluticasone propionate and salmeterol inhalation powder as indicated for the treatment of asthma and COPD
• Administering the medication as directed, with 1 inhalation twice daily by the orally inhaled route only
• Avoiding the use of additional LABA for any reason
• Following the recommended dosage and administration instructions to minimize the risk of adverse effects 2

From the Research

Best Practices for Maintaining Lung Health

• Quit smoking and avoid secondhand smoke to reduce the risk of lung diseases such as Chronic Obstructive Pulmonary Disease (COPD) and asthma 3, 4
• Get vaccinated against flu and pneumonia to prevent infections that can exacerbate lung conditions 3, 5
• Use inhalers and medications as prescribed by a healthcare provider to manage symptoms and prevent exacerbations 3, 6
• Monitor lung function regularly and track symptoms to adjust treatment plans as needed 4, 7

Managing Lung Conditions

• For COPD, use a combination of inhaled corticosteroids (ICS) and long-acting β-agonists (LABA) such as salmeterol-fluticasone to reduce the risk of exacerbations and improve lung function 3, 6
• For asthma, use a combination of ICS and LABA such as fluticasone-salmeterol to control symptoms and prevent exacerbations 5, 7
• For asthma-COPD overlap syndrome, use a combination of ICS and LABA such as fluticasone furoate/vilanterol to improve lung function and reduce symptoms 4

Treatment Options

• Fluticasone propionate/salmeterol (FSC) is a effective treatment option for COPD and asthma, and can provide greater clinical benefit compared to ipratropium bromide/albuterol 6
• Budesonide/formoterol is another treatment option for asthma, but the evidence is not sufficient to conclude that it is superior to fluticasone/salmeterol 7
• Salmeterol-fluticasone combination has been shown to be safe and effective in patients with COPD and asthma, and can provide cardio-protection 3