Keeping it all Straight: How to Plan for Medication Changes

Posted on February 15, 2022   |   

This post was authored by Kristen Szymonik, BS, RRT, AE-C

When you have a COPD exacerbation or flare-up, often your health care providers will suggest changes in your medication regimen. They may tell you to take a different dose of your medication or add new medications to your schedule. Many people with COPD take multiple medications that are used with different timing and doses. Adding new medications to this schedule can be complicated and confusing, especially when you’ve been on the same schedule for several months or years.

You might be wondering how you could possibly keep all of this information straight. First, make a list of all your medications, the dosage, and when you should use them. For example, you may write “Albuterol, 2 puffs, every 4 hours as needed.” You should also write down any special instructions like "use a spacer" or "rinse mouth after use." Once your list is complete, organize the information into a calendar, datebook, or schedule so that you have a written plan to follow. You can use the COPD Foundation's My COPD Action Plan to help you. Your health care provider can fill out the My COPD Action Plan with you and design a plan that you can follow on good days and bad. Some people also like to use reminders on their cell phones that can be set to tell them when to take their medications. Others use kitchen timers, alarm clocks, charts, calendars, or even just a regular notebook. Keep your medication schedule handy in a place where you will always see it. This could be on your fridge, by your phone, or on your bedside table.

The next step in organizing your medication schedule is knowing how to take your medications correctly. When you receive new medications after a hospitalization or flare-up, ask your health care provider how to use it properly. While some inhalers may look the same, you may have to use them differently. If you are not sure how to use your inhaler or nebulizer, you can watch instructional videos on our website. We offer videos that explain the use, care, and cleaning of all the main types of inhalers and nebulizers.

Lastly, be sure to ask your health care provider about the order in which you should take your medications. Generally speaking, bronchodilators are used before inhaled steroids or other daily medications. Bronchodilators, such as albuterol, are medications that work quickly to improve your shortness of breath. Taking a bronchodilator first allows your lungs to open up in preparation for the next dose of medication. This allows your medications to travel deeper in your lungs and work more effectively. You can learn more about the different types of COPD medications and the brand names of each one on our website.

Understanding how to use your inhalers, knowing when to take them, and remembering to take them on time are all important parts of managing your COPD. While it's not always easy to keep track of the different medications you take, tools are available to help you. And if you are not sure, ask your health care team. That is what they are there for!


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  • This is a great article, Kristen!
    I would like to mention how I go about keeping my medication schedule straight.
    Each night before bed, I write out a new medication schedule. I write them in a row, straight down the page. I list them in the order I take them, including the dosage amount. As I use one, I cross it off the list so there is no confusion or question of whether I used it or did not. If I add in an extra, I simply add that into the schedule. For example, I take a vitamin D prescription once per month. Instead of writing vitamin on my list, I write vitamin D. A list comes in handy if I have to do a Prednisone burst and a z-pack. I simply add those into the schedule.
    I keep my pill bottles lined up on top of my list. They are in order of how and when I take them. I write the initials of the prescriptions on the caps with black marker. I always check the caps and labels before taking.
    I store my unused pill bottles in a closed cabinet, away from moisture and heat. My nebulizer is on a TV table next to my bed. I keep the boxes of maintenance and rescue ampules on a bookshelf next to the TV table.
    Also, I've been advised by pharmaceutical companies TO KEEP THE INHALER BOXES until the inhalers are empty, in case there is a problem. Discard the boxes as you open new ones.
    TIP*** In an emergency situation, a medication list tells paramedics and doctors which medications you've taken. It may be helpful...
    • This is such a great idea, Debbie! i love how organized you are. I'm a "list maker" too, and I think that crossing the medications off a list is a great way to keep track of them. How often have we thought "wait a minute, did I take that pill"? Pill-a-day containers help with that, but inhaler puffs are harder to keep track of without a good system in place.

      And speaking of inhalers, you are so right! It is important to keep those boxes just in case you need them again. I actually had to file a complaint about a spray medication because it arrived only partially filled! You could see that there were only a few drops of liquid in the bottle. Luckily, I had the box and was able to contact the manufacturer with the date/lot codes and other info. If there's a problem with your medication, that kind of information is extremely important.

      Debbie shared some very helpful tips. Let's keep them coming!
    • Thank you, Kristen. We certainly can learn alot from each other. I am looking forward to hearing from others.
      Thank you, Dave, for the information about using the Propeller device.
      It can be confusing if you are not well. Your whole routine can be puzzling. Having a plan in place before a troubling time is a good idea!
  • Thanks Kristen.....I have a device from Propeller Health that goes on my Trelegy inhaler and chimes every morning to remind me to take it. I haven't missed a dose in the 3 years or more that I've been using it. They also send me a text. My pharmacy also offers an app with med reminders. They help for sure!!
  • Good article. I have one major comment and that is that when your doc recommends a new med, we need to know what this new med is replacing, or is it something we're going to be taking in addition to what we're taking now. 360 social is full of posts from people who now have a new med, especially inhalers, but aren't sure what it is or why they're taking it instead of the old med. Some aren't even sure if this med replaces something or is new to them. Especially with all the combinations available, when docs do change meds, very often people aren't at all aware of what they're getting or why.

    Does anyone have a good idea of how this information might be captured by patients? Do any of the apps available allow for this sort of information?
    • You bring up a great point, Jean. This is something I've seen in the hospital many times. Often a new medication is added but they don't realize that it actually replaces a medication that they already take. That can lead to taking too much medication, which can be dangerous.

      While I'm not aware of apps that help, there certainly could be some out there. I need to do some research! In the meantime, I would encourage folks to always ask questions when they receive a new medication. They should ask the question you posed: Does this replace a medication I already take, or is this an additional medication? This is an important safety issue, and I'm so glad you brought it up!

  • I have the chimes that Dave has described that remind me that it is time to take my Trelegy. I also agree with Jean that when the doctor changes our medicine that it is explained what that medicine replaces or is it additional. I remember one time that my doctor prescribed a nasal spray in the spring when I was having allergy issues. He did not tell me to continue with the other medication for allergies. I made the incorrect assumption that the spray was to be taken instead of and not along with my oral medication.
  • Ever since my husband Ken was diagnosed with COPD (in his case, emphysema and chronic heart failure), as well as diabetes type 2, he has had to take about 20 pills a day as well as two inhalers. Right from the start, I typed a list of all his meds, the dosage, and when he should take them. In addition to the prescribed pharmaceuticals, he takes several vitamin supplements, and everything is on the list. All the pills are in a big dosette, which he manages himself because I insisted that he has to take some responsibility for his health, seeing he caused it with 40 years of smoking. Yeah I know, tough love....
    Whenever he is given a new inhaler or tablet, I retype the list and print out several copies. One to keep in the drawer with his meds, and three more, one for the GP and specialists. Whenever he has to see a medical provider of any kind (optician, dentist, osteopath, and the regular specialists) we take a copy of the current list, and I'm often complimented on my good organisation of his meds! A couple of times we have had to call an ambulance, and they too have been impressed when they ask what meds he is on and I hand them a full list. The list also has other information at the top: Ken's full name, address and phone no, next of kin details (me), the name and numbers of his GP, cardiologist, lung specialist, pharmacy, and health fund., and his UR number at the public hospital where he has been treated numerous times. It's all there, very handy for the medical providers who need to know these things.
  • I have 3 bins.
    One bin is all my 2x/day meds (morning & evening), with my pill cutter and my pill container that has my pills for the week in sections I have labeled with the name of the med.
    One bin is for the morning only and rescue meds. It has a cover on which I affix the labels from my RX so I have the info for it refills.
    The last bin is my extra and very rarely used meds—like my Epi-pen etc.
    In the mornings, I take my meds from the mornings only and 2x/day bins. In the evening, take my meds from only the 2x/day bin.
    The system has been working great for me.
    I agree with Jean that it’s crucial that patients clarify with their provider team what any additions to meds mean—what is new med for, what does it replace, what should be watched for (side effects)?

    • The bin idea is a great one, too! I like how they are clearly separated by what time of day they're taken. I find it so interesting that there are so many creative ways to keep all those medications straight. It just goes to show that there's no "one size fits all" when it comes to managing COPD and the medications that go with it.