Doctors use several drugs to treat COPD. Many are given by using inhalers or “puffers.” In an inhaler, the drugs are in solutions in small pressurized cans with pumps. Patients put the pump's mouthpiece in their mouth and push the pump as they start to inhale deeply. They then hold their breath for about 5 to 10 seconds so that their airways absorb the medicine. The standard metered-dose inhaler releases a fixed dose of medicine in aerosol form. Examples of drugs given by inhaler include fluticasone (a steroid drug that decreases inflammation), salmeterol (a drug that expands the breathing tubes, known by the brand name Serevent [manufactured by GlaxoSmithKline]), and a combination of fluticasone and salmeterol (manufactured by GlaxoSmithKline and known by the brand name Advair in the United States and Seretide in Europe). Although these drugs can improve symptoms, their effects on inflammation and lung function over the long term have not been well studied.