The best medications for acute COPD exacerbation are albuterol and other bronchodilating adrenergic medications. These medications bind to beta-2 adrenergic receptors within the smooth muscle of your airways activating a cascade of enzymes and nucleotides that result in the relaxation of said smooth muscle within 5-15 minutes if inhaled or nebulized. These medications have a fast onset of action in order to cause rapid bronchodilation to allow relieve the bronchospasm the COPD condition can cause. Medications like salmeterol and ipratropium are also given as maintenance medications for COPD.