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Natural methods of managing shortness of breath can make a huge difference in how you feel, but sometimes the only way to take care of dyspnea with medication. Here are 10 medicines you may encounter in dyspnea treatment to treat the underlying disease.

"Why is the doctor giving me a pee pill?" the bewildered snow boarding buff asked. "I told her I was out of breath."

Sometimes the medications doctors prescribe for shortness of breath treatment don't make obvious sense. That's when it helps to keep in mind that shortness of breath, also known as dyspnea, is a symptom rather than a disease, and there are many unrelated conditions that can cause it. Here are 10 of the medications most commonly prescribed for dyspnea, why you get them, and what to expect when you take them.

1. Diamox 

Diamox (the trade name for acetozolamide), a classic "pee pill" (diuretic), is a very common treatment for preventing shortness of breath for people who spend time at high altitudes, a condition that is also known as altitude sickness. Not just for mountain climbers, it's also a common medication for hikers and snow skiers. It's also used to help people with sleep apnea breathe at night at a high altitude [1]. 

Diamox is best taken a couple of days before making the ascent, but it will work if it is started as late as the first day shortness of breath, headache, and other symptoms of inadequate oxygenation appear. Diamox can become severely toxic if it is taken with Aspirin [2], and it is also not compatible with some seizure medications, some diabetes medications (it can cause blood sugar levels to rise despite taking diabetes medicine), and Methylphenidate (Ritalin), increasing its effect [3]. It's not usually given to people who have liver or kidney disease. Despite these limitations, Diamox is very common prescribed for breathing problems that occur at high altitude.

2. Reglan

Reglan (metoclopramide) is a shortness of breath treatment given to people who get mountain sickness and can't take Diamox. Usually Reglan is an anti-vomiting drug, but taken together with the NSAID ibuprofen (sold under many brand names, including Advil and Motrin) it may work almost as well. [4]

3. Albuterol 

Albuterol (also known salbutamol or by its trade name Ventolin) is the active chemical used in rescue inhalers for asthma. It is a member of a group of medications known as beta2-adrenergic agonists, which is just a way of saying that they stimulate the nerves involved in the fight-or-flight response.

Less commonly prescribed beta2-adrenergic agonists include Orciprenaline/metaproterenol (Alupent), formoterol (Foradil), and fluticasone+salmeterol (Advair, Serevent).

These medications loosen muscles around the windpipe to allow more air to pass through, and they also dilate blood vessels to the muscles, stop digestion, and inhibit urination. Most people who use Albuterol don't have problems with it, although about 10 percent of people taking this bronchodilator will have issues with headaches, frequent sinus infections, and colds and flu [5].

Natural ways to manage dyspnea, such as pursed lip breathing and deep breathing practices make a difference in how often you get attacks, but they won't take the place of a rescue inhaler.

4. Antibiotics

Antibiotics, prescribed for at least 10 days, are usually a must when shortness of breath is caused by sinusitis [6]. Always take all the antibiotics you are prescribed, so you don't get an even worse flare-up of the infection later. In this case, the basic principle is that treating the underlying cause will also treat the shortness of breath.

5. Antidepressants

Antidepressants (especially paroxetine, sold under the trade name Paxil) are sometimes used to treat shortness of breath caused by hepatopulmonary syndrome, which is a manifestation of liver damage that comes late in the course of liver disease [7]. The antidepressant may have an effect on mental status, but it is prescribed in these cases because it has an effect on arteries similar to that of taking a nitroglycerin pill. It opens up pulmonary circulation so that breathing is easier.

6. Sodium cromoglycate

Sodium cromoglycate (sold under trade names such as Novo-Cromolyn and Intal) is used to treat allergies that cause shortness of breath, but it isn't an antihistamine. This medication works at a different stage of the process of fighting an allergic reaction by keeping mast cells from ever releasing histamine in the first place. This medication works in the same way as the plant chemical quercetin, which is one of the most important of all the natural ways to manage dyspnea [8]. Quercetin is especially abundant in wax peppers, kale, cranberries, apples, onions, grapefruit, prunes, and sweet potatoes.

7. Nitroglycerin pills

Nitroglycerin pills are a common emergency remedy for chest pain caused by angina, which is caused usually due to atherosclerosis. However, nitroglycerin pills are also sometimes taken when the only symptom is shortness of breath. Not everyone who has coronary artery disease gets chest pain, but shortness of breath on exertion (going up a flight of stairs or carrying a bag groceries, for example), especially with perspiration on the face, is a sign of poor circulation. Taking nitroglycerin relaxes arteries, but emergency room treatment (and probably hospitalization) is still needed. [9]

8. Parasite treatments

Parasite treatments are sometimes prescribed when the primary symptom is wheezing and shortness of breath, particularly when the problem is a hookworm infection. When an exceptionally large number of hookworm eggs is swallowed, the results may include shortness of breath, intense itching, vomiting, and laryngitis. [9] Many cases only require three doses of medicine to cure [10].

9. Anxiety treatments

Anxiety treatments may sometimes be indicated for shortness of breath. When shortness of breath comes with a feeling of a lump in the throat and feeling like fainting, anxiety may be the underlying cause. Feeling like you can't breathe of course makes the anxiety worse, and a negative cycle of worse and worse symptoms can follow. But treat the anxiety and the shortness of breath goes away. [11] Of course, shortness of breath caused by underlying conditions such as asthma can also lead to anxiety, in turn worsening the dyspnea.

In more recent times, it is interesting to note that benzodiazapines, which are one kind of anxiety treatment, have also been used to help COVID-19 patients manage severe dyspnea, particularly in cases of severe discomfort, when they were reaching the end of their lives, or if they were extremely distressed. In these cases, the benzodiazepine is combined with an opioid for pain relief.

10. Steroid, intravenous antibiotic, and vitamin treatments for sepsis

Steroid, intravenous antibiotic, and vitamin treatments for sepsis sometimes are required to bring breathing back to normal. When an infection enters the bloodstream through a tiny cut or scratch, sometimes the first symptom is shortness of breath, usually with a racing pulse and low blood pressure. Only treating the infection will restore normal breathing. [12]

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