DEAR DR. DONOHUE: You mentioned that there are medicines to help those with COPD. Would you please name them? — E.K.

ANSWER: COPD, chronic obstructive pulmonary disease, includes two common lung illnesses: emphysema and chronic bronchitis. Both almost always occur with each other.

The number of medicines used to improve COPD and to improve the breathing of COPD patients is large. How about if I give you the classes of medicines used and a few examples from each class? If I included all names, it would take up a huge amount of costly newspaper space.

Bronchodilators are medicines that expand breathing tubes that have become clogged with thick mucus. One kind of bronchodilators is the anticholinergics (AN-tee-COAL-in-URGE-ik) drugs. Atrovent (ipratropium) and Spiriva (tiotropium) are two such drugs. They are both inhaled.

Beta agonists are another class of bronchodilators. They work in a different way from the above two drugs. An example is Serevent Diskus (salmeterol).

Steroids, relatives of cortisone, calm inflamed airways. They, too, make it easier for air, with its oxygen, to reach the lungs and then the bloodstream. Flovent Diskus (fluticasone) is such a drug.

Oxygen isn’t really a medicine, but it is an important treatment for those with severe COPD.

Conditioning exercises are another important aspect of COPD treatment. Many hospitals sponsor such programs for their patients.

An annual influenza (flu) vaccine is a must for COPD patients.

DEAR DR. DONOHUE: My question to you is about hypertension. My blood pressure is under control the entire day.

However, in the morning it is as high as 177/93. I have been taking a second dose of my medicine at approximately midnight if I wake up. What causes the elevation in the morning? My doctor has approved the additional medicine. — F.R.

ANSWER: You usually take your blood pressure medicine in the morning, right? The morning rise in your blood pressure can be explained by the lack of any medicine in your body after a full 24 hours. If that is the case, splitting the medicine dose might be the answer for you.

If this rise is a constant thing, then taking a medicine with a longer duration of action is another way to get around the problem. That could involve taking an entirely different blood pressure drug.

Some people do experience a rise in pressure in the morning, not immediately upon wakening but after getting out of bed. The explanation is that this comes about from a release of adrenaline in the morning hours. If this is your problem, you might need a different blood pressure medicine.

The booklet on high blood pressure presents the mechanisms that raise pressure and those that lower it. Readers can obtain a copy by writing: Dr. Donohue — No. 104, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have a son, 47, who is very reluctant to see a dentist. He was told several years ago that he had the beginning of some cavities. He recently went to a dental school and had his teeth cleaned and X-rayed. He says they were supposed to call him, but he never got a call. He comes up with many reasons why he drags his feet about this. One is that he is too busy. Another is that it costs too much. Please comment. — S.B.

ANSWER: All health authorities recommend dental visits spaced six months apart. Dental health has a profound impact on total body health. He must call to find the results of his X-rays. It’s plain dumb to have them done and not find out if anything needs attention. He can’t be too busy to make a phone call.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.

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