Differentiating between asthma and COPD didn't use to be a problem. COPD was primarily a problem of older men who smoked. As more women and younger people began smoking, however, the face of COPD began to change. As a result, asthma and COPD can now sometimes be confused. Asthma and COPD occur in both young and old, men and women. We will consider factors that will help you differentiate between asthma and COPD.
Are Asthma and COPD the Same?
While the symptoms of asthma and COPD may be similar, the pathophysiology of asthma and COPD are very different. Both asthma and COPD may be considered inflammatory diseases, but the inflammation comes from different types of cells.
In the pathophysiology of asthma, inflammation results acutely from the production of eosinophils, while inflammation in COPD primarily involves the production of neutrophils and macrophages over many years.
Are the Symptoms of Asthma and COPD The Same?
Asthma and COPD can both cause the following symptoms:
However, the frequency and predominating symptoms in asthma and COPD are different. With COPD, you are more likely to experience a morning cough, increased amounts of sputum, and persistent symptoms. If you have asthma, you are more likely to experience symptoms in episodes and/or at night. Additionally, asthma symptoms are likely to occur after exposure to specific triggers.
Are Asthma and COPD Treatments the Same?
While your doctor may use some of the same medications for the treatment of asthma and COPD, the "when, why, and how" of these medications may actually be different.
The goal of treatment in asthma is to be symptom-free with near-normal lung function, while the goal of COPD treatment is to prevent the progression of damage to the lung, decrease exacerbations, and improve quality of life. Medications used in both asthma and COPD may include:
- Inhaled steroids: Inhaled steroids, such as Flovent, are advantageous in both asthma and COPD because the medication acts directly in the lung -- but inhaled steroids are used differently in asthma and COPD. In asthma, inhaled steroids are typically used first when a daily medication becomes necessary, usually after you progress from intermittent to mild persistent asthma. In COPD, inhaled steroids are added after patients develop severe COPD and multiple exacerbations.
- Anticholinergics: While short-acting anticholinergics, such as Atrovent, are used in the treatment of acute asthma exacerbations, long-acting anticholinergics like Spiriva are generally not used as a controller medication in asthma. Spiriva, however, is used relatively early in COPD because it has been associated with improvements in lung function, symptoms, and quality of life while decreasing COPD exacerbations and hospitalizations.
- Short-acting bronchodilators (SABAs): In asthma, SABAs are used for the periodic relief of acute symptoms, but once you use a SABA enough to meet the criteria for mild persistent asthma, additional medication is required. On the other hand, scheduled SABAs are one of the first treatments for COPD.
- Long-acting beta agonists (LABAs): While long-acting beta agonists like Serevent may be used as a convenient method of initial COPD treatment, LABAs are not indicated in asthma until you have moderate persistent asthma.
National Heart, Lung, and Blood Institute. Accessed: June 2, 2010. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma
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Kuebler KK, Buchsel PC, Balkstra CR. Differentiating chronic obstructive pulmonary disease from asthma. J Am Acad Nurse Pract. 2008 Sep;20(9):445-54.