Bronchodilators Health Article

Definition

Bronchodilators are medicines that help open the bronchial tubes (airways) of the lungs, allowing more air to flow through them.

Purpose

People with asthma have trouble breathing, because their airways are inflamed and become narrowed. Normally, air moves smoothly from the mouth and nose through the airways and into the tiny air sacs of the lungs as a person breathes in. Breathing out (exhaling) happens automatically when the person stops breathing in. In a person with asthma, breathing in (inhaling) is not a problem. Incoming air can slide around the blockage, because the act of breathing in makes the airways expand. The problem comes when the person with asthma tries to breathe out. The air can no longer get past the blockage, and it remains trapped in the lungs. The person can then only take shallow breaths. Bronchodilators work by relaxing the smooth muscles that line the airways. This makes the airways open wider and allows air to leave the lungs. These drugs also are used to relieve breathing problems associated with emphysema, chronic bronchitis, and other lung diseases.

Description

Some bronchodilators are inhaled, using a nebulizer or an inhalation aerosol. Others are taken as injections or by mouth. Most are available only by prescription, but a few, such as ephedrine, can be bought without a physician's prescription. Examples of bronchodilators are albuterol (Proventil, Ventolin), epinephrine (Primatene), ipratropium (Atrovent), metaproterenol (Alupent, Metaprel), and terbutaline (Brethine).

Recommended dosage

The recommended dosage depends on the type of bronchodilator and may be different for different patients. Check with the physician who prescribed the drug or the pharmacist who filled the prescription for the correct dosage.

Precautions

Bronchodilators come with patient instructions. Be sure to carefully read them before using the medicine. If there is any confusion about how to use the medicine, check with the physician or pharmacist. Always use these medicines exactly as directed. Taking larger than recommended doses or using the medicine too often can lead to serious side effects and even death.

If symptoms do not improve or if they get worse after using a bronchodilator, call a physician right away.

Although some bronchodilators are available without a physician's prescription, these medicines should not be used unless a physician has diagnosed the patient's condition as asthma.

Some asthma experts believe that the overuse of bronchodilators can cause asthma to get worse. They advise patients and their physicians to consider controlling asthma with anti-inflammatory drugs including inhaled steroids such as beclomethasone dipropionate (Beclovent, Vanceril), flunisolide (AeroBid) or triamcinolone acetonide (Azmacort) Ideally, asthma should be controlled with an inhaled steroid that is used along with the bronchodilator. The more the inhaled steroid steroid controls the inflammation that causes the asthma, the less bronchodilator the patient needs to use because symptoms are under control.

Persons with diabetes should be aware that the bronchodilator epinephrine may raise their blood sugar levels.

Patients who are using an aerosol bronchodilator and an aerosol form of either ipratropium or a corticosteroid such as beclomethasone dipropionate (Beclovent, Vanceril) should use the bronchodilator first, then wait 5 minutes before using the other medicine. Check with a physician before using any other inhaled medications or other asthma medicines. The physician must determine the proper amount of time between doses.

Some bronchodilator products contain sulfites, that trigger an allergic reaction in certain people. Anyone who has a sulfite allergy should read the label carefully or check with a physician or pharmacist before using a bronchodilator. Call a physician immediately if any of these signs of an allergic reaction to sulfite occur:

• bluish coloration of the skin
• flushed or red face or skin
• faintness
• severe dizziness
• increased wheezing or other breathing problems
• skin rash, hives, or itching
• swelling of the face, lips, or eyelids