COPD Rescue Pack

What is a COPD rescue pack?

A COPD rescue pack is intended for those who suffer with COPD (Chronic Obstructive Pulmonary Disease) to be used when a reliever inhaler (such as a blue Salbutamol inhaler) is no longer providing relief. A COPD rescue pack should be used when you are experiencing a COPD flare up. Your doctor or prescriber will be able to inform you when you should be using a COPD rescue pack.

A COPD rescue pack is an effective way to help manage your COPD and control symptoms and flare ups. People who experience frequent flare ups of at least 2 a year are most likely to benefit from having a COPD rescue pack at the ready to prepare themselves for a possible flare up. Often these patients will understand and recognise their symptoms to be able to self-diagnose. If you are unsure or are noticing symptoms different from previous flare ups you should speak to your GP or doctor.

At e-Surgery we can provide COPD rescue packs for future use and can be ordered with a simple health questionnaire. If you would like to learn more about COPD rescue packs you can find further information from the NHS.

What does a COPD rescue pack contain?

A COPD rescue pack contains a steroid called Prednisolone. You will be given 30 prednisolone tablets to be taken over 5 days (6 x 5mg tablets). Take 6 tablets each day.

It will also contain an antibiotic to help fight off any infection. This will generally be Doxycycline 100mg. You should take 2 tablets on the first day and 1 tablet a day for the following 6 days.

As an alternative to Doxycycline you may be prescribed Amoxicillin 500mg to be taken 3 times a day for 7 days.

When should a COPD rescue pack be used?

You should use your COPD rescue pack when your reliever inhaler is no longer providing relief for your COPD symptoms. If you experience frequency COPD exacerbations (at least twice a year) you will likely understand your own symptoms and be able to start treatment when you feel a COPD flare up is likely. If your symptoms change or develop from previous flare ups you should contact your doctor.

Symptoms of a COPD flare up include:

• Increased breathlessness which interferes with daily activities
• New or increased chest tightness
• Change in sputum (phlegm) quantity 
• Change in sputum (phlegm) colour
• Cough – new or increased

 

If you have had any recent changes in your general health, or have started taking any new medicines since you were given the COPD rescue pack, please contact your COPD team, GP or practice nurse before starting your COPD rescue pack. 

You are advised to contact your GP or practice nurse within three days of starting your COPD rescue pack to let them know that you have started it.

How do you use a COPD rescue pack?

When you begin to notice a COPD flare up you should begin treatment right away and inform your COPD doctor or GP. You may be given a COPD self management plan (find an example of a COPD self management plan here) which allows you and your healthcare team to manage and track your symptoms. This can be a useful tool to help work out when you should be using a COPD rescue pack.

If your breathlessness or usual symptoms are significantly worse than usual and don’t respond to increasing your reliever inhaler after 24 hours then start taking prednisolone 30mg . 

Take 6 prednisolone tablets on the first day of symptoms then 6 tablets each morning for the following 4 days.

If your sputum (snot) has changed colour you should start on a course of antibiotics. If you have been prescribed Doxycycline 200mg you should take 2 tablets on the first day and 1 tablet a day for the following 6 days.

If you have been prescribed Amoxicillin 500mg you take 3 tablets a day for 7 days.

What should I do if I have forgotten to take a dose from my COPD rescue pack?

If you do forget to take a dose, take it as soon as you remember and then carry on taking your next dose at its regular time. If you realise you’ve missed a dose but it is almost time for the next dose, do not take a double dose, skip the dose you have missed, take the next dose at its regular time and then carry on as normal with any remaining doses.

How long does a COPD rescue pack take to work?

If there is no improvement in your symptoms within 2-3 days of starting your rescue medications, your symptoms are getting worse or you have any of the symptoms below contact your GP surgery immediately, or phone 111.

• Severe breathlessness
• Chest Pain
• Drowsiness
• Confusion
• New (or worsening of existing) swelling of legs
• Inability to complete sentences
• High fever or temperature

 

In case of extreme emergency dial 999 for an ambulance. Once you have recovered from your COPD flare-up, make sure you let the surgery and arrange a review appointment with your respiratory nurse or GP and request/order a replacement Rescue Pack.

What is COPD?

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties.

It includes:

• emphysema – damage to the air sacs in the lungs
• chronic bronchitis – long-term inflammation of the airways

 

COPD is a common condition that mainly affects middle-aged or older adults who smoke. Many people do not realise they have it. The breathing problems tend to get gradually worse over time and can limit your normal activities, although treatment can help keep the condition under control.

What are the symptoms of COPD?

The main symptoms of COPD are:

• increasing breathlessness, particularly when you’re active
• a persistent chesty cough with phlegm – some people may dismiss this as just a “smoker’s cough”
• frequent chest infections
• persistent wheezing

 

Without treatment, the symptoms usually get progressively worse. There may also be periods when they get suddenly worse, known as a flare-up or exacerbation. This is often when a COPD rescue pack is used.

What causes COPD?

COPD happens when the lungs become inflamed, damaged and narrowed. The main cause is smoking, although the condition can sometimes affect people who have never smoked. The likelihood of developing COPD increases the more you smoke and the longer you’ve smoked.

Some cases of COPD are caused by long-term exposure to harmful fumes or dust. Others are the result of a rare genetic problem which means the lungs are more vulnerable to damage.

Will a COPD rescue pack help with my asthma?

Although both people with COPD and asthma may find an overlap of symptoms and treatment (such as the use of inhalers) these are two distinctly different conditions. Your doctor will be able to inform you which condition you suffer from and the best treatment for it. A COPD rescue pack will not be useful if you have asthma.

What are the side effects of a COPD rescue pack?

As with all medication there are possible side effects. Here are a few of the most common side effects for the medication that is included in a COPD rescue pack, though you should take care to always read the patient information leaflet before starting any medication.

Prednisolone

Find a full list of possible side effects in the prednisolone patient information leaflet. Some common side effects include:

• Infections, the immunosuppressive effect of prednisolone may also cause infections to flare up again (e.g. tuberculosis)
• Lower concentration of certain hormones
• Low levels of potassium, build-up of sodium in the body, increased sugar in the blood and urine, osteoporosis
• Swelling due to fluid accumulation, high blood pressure
• Thinner skin, impaired wound healing
• Muscle wasting

 

Doxycycline

Find a full list of side effects in the doxycycline patient information leaflet. Some common side effects include:

• Increased sensitivity to sunlight
• Headache
• Tummy pain
• Vomiting
• Indigestion
• Itchy skin
• Vaginal Thrush 
• Diarrhea 
• Loss of appetite 

 

Amoxicillin

Find a full list of side effects in the amoxicillin patient information leaflet. Some common side effects include:

• Diarrhea
• Skin rash
• Feeling sick (nausea)

Interactions of COPD rescue pack and other medications?

Prednisolone

Let your doctor know if you are taking any of the following medicines:

• rifampicin, isoniazid (to treat tuberculosis)
• blood thinners
• carbamazepine, phenobarbital, phenytoin
• anticholinergics (e.g. medicines for Parkinson’s disease or asthma)
• cholinesterase inhibitors
• insulin or diabetes drugs in the form of tablets
• Cortisone preparations can impair the blood sugar lowering effect of diabetes drugs
• cobicistat (for HIV infection)
• oestrogens (e.g. birth control pills)
• acetylsalicylic acid or other non-steroidal antiinflammatory agents (NSAIDs)

 

Doxycycline

Let your doctor know if you are taking any of the following medicines:

• Retinoids 
• Any medications containing iron, bismuth, or zinc salts (such as antacids) 
• Methotrexate 
• Methoxyflurane 
• Ciclosporin 
• Carbamazepin, primidone, phenytoin or any other drug that is used to treat epilepsy 
• Typhoid vaccination 
• Methysergide or Ergotamine 
• Barbiturates or any other strong sleeping tablets. 
• Some oral contraceptives 
• Sucralfate 
• Kaolin 
• Quinapril 
• Anticoagulants 
• Rifampicin 
• Penicillin based antibiotics 

 

Amoxicillin

Let your doctor know if you are taking any of the following medicines:

• allopurinol (used for gout)
• probenecid (used for gout)
• medicines to help stop blood clots (such as warfarin)
• other antibiotics (such as tetracycline)
• methotrexate (used for the treatment of cancer and severe psoriasis)

Interactions of COPD rescue pack and food/alcohol?

Prednisolone contains lactose, you have been told by your doctor that you have an intolerance to some sugars, contact them before taking this medicine.

There are no interactions between Doxycycline or Amoxicillin and food though it is recommended you avoid alcohol. It also goes without saying that smoking should be completely avoided if you have COPD.

Is there any reason why I would not be able use a COPD rescue pack?

Check with your doctor before starting a COPD rescue pack and also inform them if you have had any change in symptoms. You should not use a COPD rescue pack if you are allergic to any of the medication or ingredients and it should only be used at the start of a flare up to slow and reduce its progress, not as a preventative. Inform your doctor or prescriber of any other medication you may be on.

Contact your doctor if your condition has not improved within three days.

Can I buy a COPD rescue pack online?

Yes you can order a COPD rescue pack online from e-Surgery for future use. When buying COPD rescue packs or any other medication online, always look for the green GPhC and MHRA logo on the bottom of each page you visit. This ensure that the website is operating legally.

Where can I get more information about COPD rescue packs online?

You can find more information about COPD rescue packs from the NHS. You can also find more information about the individual medications it contains in their patient information leaflets: 

• prednisolone patient information leaflet
• doxycycline patient information leaflet
• amoxicillin patient information leaflet

How do I store my COPD rescue pack?

Store your COPD Rescue Pack in a safe place at home that is easily within reach to you, but out of the reach of children. Do not use any of the medication in the COPD rescue pack after the expiry date on the box.

How will my COPD rescue pack be delivered?

e-Surgery uses Royal Mail delivery with choices starting from Royal mail 48 tracked delivery, Royal Mail tracked 24 and Royal Mail 1pm special delivery (discover more about e-Surgery delivery). Your COPD rescue pack will arrive in discreet, recyclable packaging at a delivery address of your choice. Find out to recycle packaging from e-Surgery.

How to dispose of my COPD rescue pack?

The medication in a COPD rescue pack will come in blister packs that are not currently recyclable, so once they have been used can be disposed of in a general waste bin. If the COPD rescue pack is unfinished dispose of medication safely and drop them off at a local pharmacy. Cardboard packaging and paper patient information leaflets are recyclable. For any more information on disposal of COPD rescue packs you can use our free Ask-a-Pharmacist service.