DEAR MAYO CLINIC: I was recently diagnosed with chronic obstructive pulmonary disease (COPD). Why do I have different inhalers?

Bronchodilators commonly are prescribed for people with COPD. Bronchodilators relax the muscles around your airways so that you can breathe better. They usually come in the form of an inhaler, which allows the medicine quick access to your lungs as you breathe it in. Two of the most commonly used classes of bronchodilators are beta agonists and anticholinergics.

Some bronchodilators offer quick relief. These are called short-acting bronchodilators. They typically start working in 15 to 30 minutes, and last about four to six hours. Your doctor may prescribe a short-acting bronchodilator if your COPD is mild and you only have symptoms every once in a while. Examples of short-acting bronchodilators are albuterol (ProAir HFA, Ventolin

HFA, and other brand names), levalbuterol (Xopenex) and ipratropium (Atrovent HFA).

Most long-acting bronchodilators don't act as quickly but last longer — 12 to 24 hours or more — to relieve symptoms. Long-acting bronchodilators usually are prescribed when symptoms occur frequently. These medications act as maintenance therapy by keeping symptoms from developing in the first place. Most are not as good at providing immediate relief. Examples of long-acting bronchodilators are formoterol (Foradil, Perforomist), salmeterol (Serevent), and tiotropium (Spiriva), and there are numerous others.

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If your COPD is moderate to severe, your doctor likely will recommend both types — a short-acting bronchodilator for quick relief when needed and one or more long-acting ones that you take every day to keep symptoms at bay. Consider labeling each with a marker, so you can quickly tell which is for quick relief and which is for regular treatment.

Some people with COPD are prone to frequent exacerbations, or flare-ups, of symptoms, which may require the use of antibiotics or steroids, or both. A number of medications help reduce the risk of exacerbations, including both classes of long-acting bronchodilators, as well as inhaled corticosteroids, an antibiotic (azithromycin), and roflumilast (Daliresp).

If you have frequent exacerbations despite daily use of a long-acting bronchodilator, talk to your doctor. A combination with additional medicines may work better for you. (Adapted from Mayo Clinic Health Letter) — Paul Scanlon, M.D., Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester.


Jogging tips for beginners

READERS:Just 30 to 60 minutes of weekly jogging can add up to substantial health benefits. If you're considering jogging, here are some tips:

Check with your doctor: Ask if it's OK to try jogging. This is especially important if you have a history of cardiovascular disease or diabetes.

Develop baseline fitness: Work up to being able to walk 150 minutes a week. Then try adding brief bouts — such as one minute — of faster walking throughout your walk.

Dress for the occasion: It likely will be worth it to purchase a pair of comfortable and supportive walking or running shoes. It also will be more comfortable to wear clothing that's lighter and looser than street clothing. Because you'll be producing heat, you can dress in lighter clothing for jogging than for walking.

Take it slow: Start by walking. After five to 10 minutes, try jogging for a minute, or even 30 seconds, then return to a walking pace to finish the session. Over days, weeks and months, gradually incorporate additional 30-second or 1-minute bouts of jogging into your walk, or lengthen the bouts of jogging until you reach five to 10 minutes of jogging most days, or longer on fewer days.

Avoid injury: Injury isn't as likely with easy jogging in small amounts. Further reduce injury risk by staying light on your feet by taking fairly quick steps — such as about 170 to 180 steps a minute. Work on running tall with good posture. (Adapted from Mayo Clinic Health Letter)