Need sprays. Most COPD pts. Require a long acting bronchodilator and steroid inhalers. Medicines like advair or symbicort (budesonide and formoterol) are the most popular maintenance medications. For frequent use every four hours or as needed besides the previous we use anticholinergics bronchodilators like ipapropium or atrovent, the combination with beta agonists Combivent or the cheapest is a bronchodilator like albuterol.