Shortness of breath, wheezing, and feelings of tightness in the chest are all characteristic of chronic obstructive pulmonary disease — and bronchodilators can help alleviate all of them. These medications will be introduced to patients' lives as soon as they need them. There are many kinds, however, and they perform different functions.
1. How do bronchodilators work?
The word "bronchodilator" already gives useful insights, as these medications widen the bronchi (airways) and relax the lungs. This, in turn, allows more air to come into the lungs, alleviating shortness of breath. Brochodilators are often used to treat asthma as well as chronic obstructive pulmonary disease, and they can provide quick as well as long-acting relief from symptoms.
2. What kinds of bronchodilators might you be prescribed?
Bronchodilators can be short-acting ("rescue inhalers) and long-acting (bringing you relief over a longer period of time.
While short-acting bronchodilators include:
- Short-acting beta-agonist bronchodilators or "SABAs"
- Short-acting antimuscarinic bronchodilators or "SAMAs"
Long-acting bronchodilators come in two main types:
- Long-acting beta-agonists (“LABAs”)
- Long-acting muscarinic agonists bronchodilators, abbrevidtated as "LAMAs"
The beta-2 agonists you'll come across in inhalers commonly include:
- Salbutamol, albuterol (generic names for a medication also sold under the brand name Ventolin)
- Terbutaline (Bricanyl)
- Salmeterol (Serevent)
- Formoterol (Oxeze)
- Indacterol (Onbrez)
Anticholinergic inhalers, some examples of which include:
- Tiotropium (Spiriva or Respimat)
- Ipratropium bromide (Atrovent)
- Aclidinium (Tudorza)
- Glycopyrronium (Seebri)
3. What role can short-acting bronchodilators play in your COPD treatment?
Short-acting bronchodilators are used to treat acute symptoms immediately. They can offer immediate and effective relief, which is why they are commonly referred to as rescue or relief inhalers. Though effective in the short term, these inhalers wear off fairly quickly.
SABAs, for instance, are often said to alleviate symptoms within three to five minutes, though anyone who has used them will know that the relief can even be quicker. The effects they confer will wear off in four to six hours, however. SAMAs kick in about 15 minutes and are used as a maintenance treatment.
4. What do long-acting bronchodilators do for you?
While rescue inhalers are a "stop-gap", as it were, though an effective one, long-acting bronchodilators are used according to a predetermined schedule to provide patients with lasting symptom relief. When these medications are in your system all the time, they can keep your need for rescue inhalers to a minimum. Examples include LABAs and LAMAs, as well as methylxanthines and phosphodiesterase-4 (PDE4) inhibitors.
5. When should you use which bronchodilators?
Ask your doctor and stick to the instructions, which will include using short-acting bronchodilators as needed. When you're first diagnosed with COPD, if it was caught early, rescue inhalers will be the first medication to be introduced, and often the only kind you will need for a good while.
Because long-acting bronchodilators are used for maintenance — that's to say, to help you feel better all the time, when this becomes necessary — they're going to become part of your life when your symptoms are more severe. Doses can be increased as your COPD progresses.
6. How do I use all these different kinds of inhalers?
While people with more severe COPD who cannot use inhalers effectively may be advised to opt for a nebulizer, though which bronchodilators can be breathed in with the help of a mask or mouthpiece and an air compressed for a longer period of time, newly diagnosed patients will almost certainly use inhalers. These actually come in quite a dew different types, and a new inhaler may look intimidating when you first get it.
The main types are:
- Metered-dose inhalers (MDIs), which consist of a pressurized canister and a plastic casing of which the mouthpiece that will deliver your medication is part. They get your medication to your lungs in mist (liquid) form.
- Dry-powdered inhalers (DPIs) have a plastic system that delivers your medication in the form of a fine dry powder.
7. What are combination inhalers?
Combination inhalers are inhalers that carry two different kinds of medicine — both a long- and short-acting bronchodilator, or a bronchodilator and a steroid. These can be very convenient for patients in the later stages of COPD, and work better than either medication on its own in some cases.
8. Do bronchodilators have any side effects?
The short answer is that this depends on the kind you're using as well as on blind luck, but side effects associated with bronchodilators include:
- Trembling (often in the hands)
- A dry mouth
- Heart palpitations
- Headaches
- Muscle cramping
- Feeling nauseous
- Diarrhea
Just because these side effects are possible, don't assume you'll definitely experience them. Do let your doctor know if you do encounter side effects.
9. Can Bronchodilators interact with other medicines?
Yes. All medications can interact with other medications. Sometimes this is actually a positive, but it can also be dangerous. It's always important that your prescribing doctor knows exactly what other medications you're using in addition to the one they're suggesting now, and this includes over-the-counter medications.
Bronchodilators, especially theophylline, may interact with:
- Some medications prescribed for mental health reasons, including some antidepressants (particularly monoamine oxidase inhibitors and tricyclic antidepressants), lithium, and benzodiazepines.
- Diuretics, often prescribed to people with high blood pressure
- Digoxin, which is used in the treatment of arrhythmias
- Quinolones, an antibiotic