COPD exacerbations are sudden attacks or flare-ups where breathing and coughing get worse.


The three most common causes of exacerbations are:

  • Respiratory infections (e.g. pneumonia, bronchitis)
  • Other medical problems with COPD like an irregular heart beat (arrhythmia) or heart failure
  • Air pollution

Signs and Symptoms

Sudden and worsening symptoms include:

  • More wheezing and shortness of breath
  • More coughing and mucus may be a different color
  • Depression or confusion
  • Insomnia
  • Tiredness


Therapy depends on the severity of symptoms and may include:

  • Inhaling bronchodilators: quick acting drugs that make it easier to breathe by design the bronchial tubes. These are: Anticholinergics (e.g. ipratropium), Beta-2-agonists (e.g. albuterol), Intravenous theophylline if other drugs don't work
  • Oxygen- to increase the amount of circulating oxygen
  • Intravenous (IV) fluids to decrease dehydration
  • Oral corticosteroids- decrease swelling in the airways, making breathing easier
  • Ventilation- machine to help breathing if medications don't work
  • Diuretics- (when heart failure is diagnosed) takes excess water from body by making more urine
  • Antibiotics- to prevent pneumonia or other bacterial lung infections