Breathing Easier Through Treatment and Management

Causes of Bronchitis

A variety of factors have been recognized as triggers for bronchitis, including exposure to irritants (chemical and pollution), but the most common causes of acute bronchitis include the same viruses that cause the common cold and the flu.^1-3 Bacterial infection may also cause acute bronchitis.^1-3 The most frequent cause of chronic bronchitis is tobacco use, representing an estimated 80% to 90% of chronic bronchitis cases.^1-3 According to the American Lung Association, chronic bronchitis is one of the 2 main types of chronic obstructive pulmonary disease (COPD).^1,3,5 Most individuals with COPD have both emphysema and chronic bronchitis.^1,3,5,6

Airway obstruction in chronic bronchitis occurs because swelling and excessive mucus production cause the bronchioles to become narrower than usual.⁷ Chronic bronchitis may be a manifestation of a history of several acute bronchitis attacks, or it may have a gradual onset due to a history of heavy tobacco use or inhalation of irritants such as secondhand smoke or other pollutants. ^1,2,6,7 The most common sign of bronchitis is cough, followed by possible sputum production; the condition appears to occur most frequently during the winter months.^7,8 Other common signs and symptoms of bronchitis are outlined in Online Table 2.^7,8

TABLE 2: SIGNS AND SYMPTOMS OF BRONCHITIS

Acute Bronchitis

Chronic Bronchitis

• Hacking cough that is productive or minimally productive and persists for 10 to 20 days
• If mucus is colored, an infection may be present
• Possible low-grade fever
• Tenderness or soreness in the chest with coughing
• Sore throat from constant coughing

• Chronic cough and sputum that last for at least 3 months
• Increased mucus production
• Sputum may be clear or yellowish or greenish depending on the presence of a bacterial infection
• Dyspnea, wheezing
• Frequent clearing of the throat
• Fatigue

Adapted from references 7 and 8.

Managing and Treating Bronchitis

The main goals in treating both acute and chronic bronchitis are relieving symptoms, enabling the patient to breathe more comfortably, and improving overall quality of life.

Acute Bronchitis

Whereas acute bronchitis generally resolves quickly in healthy patients, cardiopulmonary or other comorbid conditions may exacerbate the condition.¹ Typically, treatment for acute bronchitis is symptomatic and may entail the use of analgesics, antipyretics, antitussives, and/or expectorants.

The majority of acute bronchitis cases are caused by viruses; therefore, the use of antibiotics is typically not recommended.^1,2,6 Due to the overuse of antibiotics and ongoing concerns about drug-resistant organisms, the CDC and other health organizations oppose the routine use of antibiotics in uncomplicated bronchitis unless the patient has a bacterial infection.^1,8,9 Results from a recent study show that overuse of antibiotics in acute bronchitis rose by 70% between 1996 and 2010 despite CDC guidelines. ¹⁰

Patients with acute bronchitis should be advised to quit smoking, avoid exposure to secondhand smoke, implement good hand washing techniques into daily routine, and maintain recommended immunizations, especially the yearly influenza vaccine.⁹

Chronic Bronchitis

The goals of treating chronic bronchitis are to alleviate symptoms, prevent further complications, and slow progression of the disease.^1,3,9,11-13 Chronic bronchitis may require a combination of therapies, including the use of bronchodilator medications, inhaled steroids, antibiotics, vaccines, oxygen therapy, and pulmonary rehabilitation.^1,3,9,11-13 The two major drug classes used to treat chronic bronchitis include bronchodilators and steroids.^1,9,11-13 Short-acting beta-agonists such as ipratropium bromide are often used for controlling bronchospasms, dyspnea, and chronic cough in stable patients with chronic bronchitis.^1,9,11-13 In some cases, a long-acting beta-agonist in conjunction with an inhaled corticosteroid may be employed to control chronic cough. ^1,9,11-13 Results from some studies suggest that treatment with mucolytics has been associated with a small decrease in acute exacerbations in patients with chronic bronchitis.^1,14 The use of antibiotics may be needed for chronic bronchitis exacerbations caused by bacterial infections; the mostly commonly used antibiotics include macrolides, quinolones, and amoxicillin/clavulanate.^1,15,16

Some studies have concluded that the most effective measures for managing chronic bronchitis are smoking cessation and avoidance of irritants,especially tobacco fumes.^1,9,11,13 Some patients with chronic bronchitis may require pulmonary rehabilitation (in which the patient is taught exercises and other ways to ease breathing), supplemental oxygen therapy, and lifestyle modifications such as quitting smoking, getting plenty of rest, and avoiding irritants such as aerosol sprays, dust, and chemicals.¹² Because chronic bronchitis can increase a patient’s risk for pulmonary infection, patients should be encouraged to obtain a yearly influenza vaccination; to protect against pneumonia, patients should also consider the pneumococcal vaccination. ^1,17,18

Newly Approved Medications

In August 2014, the FDA approved olodaterol (Striverdi Respimat, Boehringer Ingelheim) inhalation spray, a long-acting beta₂-agonist bronchodilator indicated for the treatment of airflow obstruction in patients with COPD, including chronic bronchitis and/or emphysema¹⁹ (Online Table 3). This long-term maintenance medication is administered once daily. The most commonly reported adverse reactions include nasopharyngitis, upper respiratory tract infection, urinary tract infection, cough, dizziness rash, diarrhea, back pain, and arthralgia.¹⁹

TABLE 3: PHARMACOLOGIC THERAPIES FOR BRONCHITIS

Drug Class

Indication

Examples

Antitussives/expectorants

These agents are used to treat minor cough resulting from bronchial and throat irritation. For patients with chronic bronchitis, central cough suppressants such as codeine and dextromethorphan

are recommended only for short-term symptomatic relief of cough.

· Dextromethorphan, codeine (antitussives)

· Guaifenesin (expectorant)

Bronchodilators

Bronchodilators aid in relieving the symptoms of chronic bronchitis by relaxing and opening the air passages in the lungs.

Beta₂-adrenergic agonists, short-acting bronchodilators:

· Albuterol (Proventil HFA, Ventolin HFA, ProAir HFA)

· Levalbuterol (Xopenex, Xopenex HFA)

· Metaproterenol

Beta₂-adrenergic agonists, long-acting bronchodilators

· Indacterol (Arcapta Neohaler)

· Salmeterol (Serevent Diskus)

· Formoterol (Performist, Foradil)

· Arformoterol (Brovana)

· Olodaterol (Striverdi Respimat)

Anticholinergics

· Tiotropium (Spiriva)

· Ipratropium (Atrovent HFA)

· Aclidinium (Tudorza Pressair)

· Umeclidinium (Incruse Ellipta)

Xanthine derivatives

· Theophylline (Elixophyllin, Theo-24, Theochron)

Long-acting bronchodilator/corticosteroid combinations

Combination therapy is suggested when a patient’s symptoms remain uncontrolled with bronchodilator monotherapy.

· Budesonide/formoterol (Symbicort)

· Fluticasone/salmeterol (Advair Diskus)

· Fluticasone/vilanterol (Breo Ellipta)

Beta-adrenergic agonist/anticholinergic agent combinations

These agents offer the quick onset of a beta-adrenergic agonist with the prolonged action of an anticholinergic agent.

· Umeclidinium/vilanterol (Anoro Ellipta)

· Ipratropium/albuterol (DuoNeb, Combivent Respimat)

Systemic corticosteroids

For patients with an acute exacerbation of chronic bronchitis, a short course of systemic corticosteroid therapy is sometimes administered; studies report positive results.

· Methylprednisolone

· Prednisone

Inhaled corticosteroids

An inhaled corticosteroid may provide symptom relief in some patients.

· Budesonide (Pulmicort, Pulmicort Flexhaler)

Phosphodiesterase-4 inhibitors

These anti-inflammatory drugs are used for acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease. They have been shown to decrease exacerbations, relieve dyspnea, and improve lung function.

· Roflumilast (Daliresp)

Analgesics/antipyretics

These agents are beneficial in providing symptomatic relief of fatigue, malaise, and fever associated with illness.

· Ibuprofen

· Acetaminophen

· Naproxen

Antibiotics

Occasionally, antibiotics are used to treat chronic bronchitis exacerbations caused by bacterial infections. Broad-spectrum antibiotics are often the choice.

· Penicillin

· Cephalosporins

· Fluoroquinolones

· Macrolides

· Sulfonamides

· Tetracyclines

Adapted from references 1, 3, 9, 10, 12-18, 21.

In April 2014, the FDA also approved umeclidinium inhalation powder (Incruse Ellipta, GlaxoSmithKline), a long-acting muscarinic antagonist monotherapy, a type of bronchodilator also known as a long-acting anticholinergic. ²⁰ It is indicated for the long-term, once-daily maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and/or emphysema.²⁰ It is available as a powder for inhalation via a plastic inhaler.²⁰ The most commonly reported adverse effects include cough, arthralgia, upper respiratory tract infection, and nasopharyngitis.²⁰

The Pharmacist’s Role

Pharmacists can be an instrumental resource for patients with bronchitis via medication counseling, keeping them abreast of new developments in the treatment and management of bronchitis, and encouraging them to adhere to their recommended therapy. During couseling, patients should be educated on the proper use of inhalation devices to ensure appropriate dose delivery. If a patient is still smoking, pharmacists should stress the importance of smoking cessation and encourage the patient to discuss possible smoking cessation therapies with his or her primary health care provider. Studies show that 50% of patients with chronic bronchitis who have a history of smoking will no longer cough after 1 month of smoking cessation, and 80% will no longer cough after 2 months. ¹² Patients should also be reminded to eat a balanced diet and get plenty of rest when needed. For more information, see Online Table 4 and visit ClinicalTrials.gov at http://clinicaltrials.gov/search/open/condition=%22Bronchitis,+Chronic%22.

TABLE 4: EDUCATIONAL RESOURCES REGARDING BRONCHITIS

· American Thoracic Society: http://patients.thoracic.org/?page_id=43

· COPD Foundation: www.copdfoundation.org/What-is-COPD/COPD-Facts/Glossary.aspx

· National Heart, Lung, and Blood Institute: www.nhlbi.nih.gov/health/health-topics/topics/copd/

· American Lung Association: www.lung.org/lung-disease/copd/about-copd/

Ms. Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.

References

1. Fayyaz J, Olade RB, Lessnau K-D. Bronchitis. Medscape website. http://emedicine.medscape.com/article/297108-overview#a0101?cc=aHR0cDovL2VtZWRpY2luZS5tZWRzY2FwZS5jb20vYXJ0aWNsZS8yOTcxMDgtb3ZlcnZpZXcjYTAxMDE=&cookieCheck=1. Updated March 28, 2014. Accessed October 6, 2014.

2. American Lung Association. Trends in COPD (chronic bronchitis and emphysema): Morbidity and mortality. American Lung Association website. www.lung.org/finding-cures/our-research/trend-reports/copd-trend-report.pdf. Updated March 2013. Accessed October 6, 2014.

3. Chronic bronchitis. PDRhealth.com website. www.pdrhealth.com/diseases/chronic-bronchitis. Accessed October 6, 2014.

4. Freid VM, Bernstein AB, Bush A. Multiple chronic conditions among adults aged 45 and over: trends over the past 10 years. Centers for Disease Control and Prevention website. www.cdc.gov/nchs/data/databriefs/db100.htm. Updated July 31, 2012. Accessed October 6, 2014.

5. Chronic obstructive pulmonary disease (COPD) fact sheet. American Lung Association website. www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html. Updated May 2014. Accessed October 6, 2014.

6. What is COPD? National Heart, Lung, and Blood Institute website. www.nhlbi.nih.gov/health/health-topics/topics/copd/. Updated July 31, 2013. Accessed October 6, 2014.

7. What is chronic obstructive pulmonary disease (COPD)? American Thoracic Society website. www.thoracic.org/clinical/copd-guidelines/for-patients/what-is-chronic-obstructive-pulmonary-disease-copd.php. Accessed October 6, 2014.

8. What are the signs and symptoms of bronchitis? National Heart, Lung, and Blood Institute website. www.nhlbi.nih.gov/health/health-topics/topics/brnchi/signs.html. Updated May 1, 2009. Accessed October 6, 2014.

9. Bronchitis (chest cold). Centers for Disease Control and Prevention website. www.cdc.gov/getsmart/antibiotic-use/uri/bronchitis.html. Updated September 30, 2013. Accessed October 6, 2014.Barnett ML, Linder JA. Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010. JAMA. 2014;311(19):2020-2022.

10. Braman SS. Chronic cough due to chronic bronchitis: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):104S-115S.

11. Davis CP. Chronic bronchitis. MedicineNet.com website. www.medicinenet.com/chronic_bronchitis/page6.htm#what_is_the_treatment_for_chronic_bronchitis. Updated November 26, 2013. Accessed October 6, 2014.

12. Braman SS. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines. Chest. Jan 2006;129(1 Suppl):95S-103S.

13. Poole PJ, Black PN. Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2010;2:CD001287.

14. Budey MM, Weidemann HP. Acute bacterial exacerbation of chronic bronchitis. Cleveland Clinic website. www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/pulmonary/acute-bacterial-exacerbation-chronic-bronchitis/. Accessed October 6, 2014.

15. Siempos II, Dimopoulos G, Korbila IP, Manta K, Falagas ME. Macrolides, quinolones and amoxicillin/clavulanate for chronic bronchitis: a meta-analysis. Eur Respir J. 2007;29(6):1127-1137.

16. Chronic obstructive pulmonary disease (COPD). Merck Manuals website. www.merckmanuals.com/professional/pulmonary_disorders/chronic_obstructive_pulmonary_disease_and_related_disorders/chronic_obstructive_pulmonary_disease_copd.html. Updated June 2014. Accessed October 6, 2014.

17. Living with chronic bronchitis. National Heart, Lung, and Blood Institute website. www.nhlbi.nih.gov/health/health-topics/topics/brnchi/livingwith.html. Updated May 1, 2009. Accessed October 6, 2014.

18. FDA approves Boehringer Ingelheim’s Striverdi® Respimat® (olodaterol) inhalation spray for maintenance treatment of COPD. Boehringer Ingelheim website. http://us.boehringer-ingelheim.com/news_events/press_releases/press_release_archive/2014/08-01-14-fda-approves-boehringer-ingelheims-striverdi-respimat-olodaterol-inhalation-spray-maintenance-treatment-copd. html. Updated August 1, 2014. Accessed October 6, 2014.

19. GSK receives approval for Incruse™ Ellipta® (umeclidinium) in the US for the treatment of COPD. GlaxoSmithKline website. http://us.gsk.com/en-us/media/press-releases/2014/gsk-receives-approval-for-incruse-ellipta-umeclidinium-in-the-us-for-the-treatment-of-copdandnbsp/. Updated April 30, 2014. Accessed October 6, 2014.

20. Mosenifar Z, Harrington A, Nikhanj NS, et al. Chronic obstructive pulmonary disease treatment & management. Medscape website. http://emedicine.medscape.com/article/297664-treatment. Updated September 25, 2014. Accessed October 6, 2014.

Bronchitis Treatments

Acute and chronic bronchitis are treated with fundamentally different approaches, although there are a few treatments that can be used for both conditions. Overall, the cornerstone of therapy for both forms is based on improving comfort, promoting optimal breathing, and reducing the cough.

The most common treatments for acute bronchitis include rest and symptomatic treatment when the inflammation is the result of a viral infection. When a bacterial infection is the cause, antibiotics may be used as well. Chronic bronchitis, on the other hand, is managed with medications that decrease inflammation of the bronchi, such as inhaled or oral steroids, as well as lifestyle modifications such as smoking cessation.

Verywell / Lara Antal

Home Remedies and Lifestyle

If you are diagnosed with acute or chronic bronchitis, you will probably not need to be hospitalized for it. For both acute and chronic bronchitis, a large focus of your treatment is based on home remedies and lifestyle modifications.

• Avoid smoke and fumes: Both acute and chronic bronchitis can be exacerbated by cigarette smoke, industrial inhalants, and fumes in the environment, such as smoke from a grill. Whenever possible, stay away from inhaled irritants, as they can induce an increased inflammatory reaction of your bronchi. 
• Humidifiers: Using a humidifier may relieve discomfort when you have acute bronchitis, and sometimes this helps with chronic bronchitis as well. Humidifiers add moisture to the air, making it easier to breathe and loosening mucus. It can even relieve some of the pain that ensues from breathing dry air.

Acute Bronchitis

• Rest: Acute bronchitis can cause you to feel very tired. This is due to both the infection and the persistent cough. It is important to rest as much as possible when you are sick. 
• Fluids: Drinking clear liquids when you have any type of respiratory infection is important because you need to stay hydrated, which helps thin the mucus in your chest and throat.

Over-the-Counter Therapies

A number of over-the-counter medications can help relieve some of the symptoms of both acute and chronic bronchitis. In general, these medications are more effective for short-term use if you have acute bronchitis. Most of the time, your doctor will recommend prescription-strength medication that has a more lasting effect for chronic bronchitis.  

• Decongestants: Decongestants such as Sudafed (pseudoephedrine) and Afrin (oxymetazoline) loosen and help drain the mucus that may be in your sinuses, making it easier for you to breathe.

There is some controversy about abuse of decongestants, so it is important to be responsible and use them conservatively. Use decongestants only if they relieve your symptoms, and for no longer than a few days at a time.

• Pain relievers: Pain relievers and fever reducers such as acetaminophen and ibuprofen can help relieve the chest pain and soreness that you may experience from coughing when you have bronchitis.
• Fever reducers: Many of the medications that can reduce your fever also relieve mild pain, so these over-the-counter medications can do double duty. Do not take them in doses higher than recommended, and be sure to tell your doctor or your child’s pediatrician about over-the-counter medications that you are using.  
• Cough medications: Cough suppressants or expectorants may be helpful if your cough is dry or unproductive. If you have a persistent cough with chronic bronchitis, your doctor may give you a prescription cough suppressant. 

Prescriptions

Prescription treatments for bronchitis are given for comfort, and some prescription treatments can help the disease itself to get better. 

• Antibiotics: Most cases of acute bronchitis are caused by viral infections, which means that they cannot be treated with antibiotics. Taking them will not help you get better any faster and can lead to other problems, such as antibiotic resistance. If you have acute bronchitis caused by a bacterial infection, you may need to take prescription antibiotics. The specific antibiotic is determined based on the likely bacterial organism.

• Bronchodilators: Bronchodilators such as Proventil (albuterol) relax the muscles around the bronchi, allowing them to become wider. This helps remove bronchial secretions while relieving bronchospasm and reducing airway obstruction. Your wheezing and chest tightness may temporarily improve, and more oxygen can be distributed to your lungs to improve your energy level. Some of these medications are referred to as rescue inhalers because they work quickly and are used to treat sudden episodes of shortness of breath related to bronchospasm.
• Steroids: Oral steroids may be used to treat chronic bronchitis when symptoms rapidly get worse. Inhaled steroids are typically used to treat stable symptoms or when symptoms are slowly getting worse. 
• Phosphodiesterase-4 (PDE4) Inhibitors: PDE4 inhibitors Daliresp (roflumilast) are a class of medication that treats inflammation associated with lung disease. A once-daily oral medication, PDE4 inhibitors help reduce exacerbation of chronic bronchitis, typically with minimal side effects.

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Specialist-Driven Procedures

Several procedures can help relieve the symptoms and congestion of chronic bronchitis. These procedures are primarily non-invasive and easy to tolerate but must be directed by an experienced specialist. 

• Chest physiotherapy: This procedure, which may also be referred to as chest percussion, is a technique which involves clapping on the chest and/or back to help loosen mucus and make it easier to cough up. It is often used with postural drainage and can be performed using cupped hands or an airway clearance device.
• Postural drainage: This technique uses gravity to assist with the removal of mucus from the airways. Both chest physiotherapy and postural drainage work best after a bronchodilator treatment.
• Airway clearance devices: These devices are used in conjunction with chest therapy and postural drainage to better ensure mucus clearance from the lungs. The devices have been shown to improve results compared to physiotherapy and drainage alone. They are relatively affordable and easy to use, and your therapist or doctor may recommend a device if you have chronic bronchitis.
  Positive expiratory pressure (PEP) devices allow you to breathe against air pressure.
• High-frequency oscillating devices, such as the Flutter mucus clearance device and the Acapella vibratory PEP device, gently allow the small and large airways to vibrate.
• The Lung Flute, a hand-held device, generates low-frequency sound waves into the airways.

Complementary Medicine (CAM)

There are a number of alternative therapies used for bronchitis. A few have been subjected to research, with limited results:

• Eucalyptus oil:  Eucalyptus may possess antiviral properties; using the oil with eucalyptus steam inhalation may decrease some of the symptoms of acute bronchitis.
• Pelargonium sidoides: Also known as umckaloabo, P. sidoides is an herbal remedy that may be effective in relieving symptoms of acute bronchitis.
• Slippery elm: In tea form, slippery elm may help relieve a sore throat that can be associated with bronchitis. Slippery elm contains mucilage, a gel-like substance that may reduce inflammation. 

Frequently Asked Questions

How is bronchitis treated in people with asthma?

Acute bronchitis can lead to secondary infections in people with asthma and other ongoing respiratory problems, including chronic obstructive pulmonary disease (COPD) and cystic fibrosis, as well as those with heart failure. Doctors will often prescribe antibiotics to treat acute bronchitis in these patients to lower the risk of pneumonia or other complications.

How is wheezing in bronchitis treated?

Sipping hot beverages is sometimes helpful for wheezing, in particular those containing caffeine, which has been shown to temporarily relax airways in people with asthma. A nonsteroidal anti-inflammatory drugs (NSAID) such as Advil (ibuprofen) might also help reduce inflammation in the airways and temper wheezing and other bronchitis symptoms as will kicking the habit for people who smoke.

What can I do to recover from bronchitis faster?

Follow your doctor’s orders to stay well-hydrated and take it easy. Don’t push yourself, even if that means taking time off from work and turning over household tasks and other responsibilities to others. Get plenty of sleep as well: Research has found sleep makes it easier for immune cells to fight infection.

What happens if bronchitis isn’t treated?

Acute bronchitis caused by a virus will resolve on its own without treatment. For bronchitis caused by a bacterial infection, antibiotics may be prescribed but aren’t always advisable. In addition to concerns about antibiotic resistance, research has found antibiotics to be only slightly effective for bronchitis. In one study, they reduced the amount of time a person had symptoms by only half a day.

How is acute bronchitis treated during pregnancy?

Bronchitis requires special attention during pregnancy due to concerns about the health of the developing fetus and changes in the maternal immune system that may increase susceptibility to infection.Although rare, a viral infection can lead to complications during pregnancy that can affect both parent and baby. If you’re pregnant and develop bronchitis, let your doctor know right away so they can determine how best to relieve your symptoms and monitor the progression of the infection.

Diagnosis and Treatment of Acute Bronchitis

1. Schappert SM,
Burt CW.
Ambulatory care visits to physicians offices, hospital outpatient departments, and emergency departments: United States, 2001–02. Vital Health Stat 13.
2006;(159):1–66….

2. Linder JA,
Sim I.
Antibiotic treatment of acute bronchitis in smokers: a systematic review. J Gen Intern Med.
2002;17(3):230–234.

3. Little P,
Rumsby K,
Kelly J,

et al.
Information leaflet and antibiotic prescribing strategies for acute lower respiratory tract infection: a randomized controlled trial. JAMA.
2005;293(24):3029–3035.

4. Metlay JP,
Kapoor WN,
Fine MJ.
Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA.
1997;278(17):1440–1445.

5. Wenzel RP,
Fowler AA III.
Clinical practice. Acute bronchitis. N Engl J Med.
2006;355(20):2125–2130.

6. Boldy DA,
Skidmore SJ,
Ayres JG.
Acute bronchitis in the community: clinical features, infective factors, changes in pulmonary function and bronchial reactivity to histamine. Respir Med.
1990;84(5):377–385.

7. Gonzales R,
Bartlett JG,
Besser RE,

et al.;
American Academy of Family Physicians, American College of Physicians-American Society of Internal Medicine, Centers for Disease Control, Infectious Diseases Society of America.
Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: background. Ann Intern Med.
2001;134(6):521–529.

8. Linder JA,
Sim I.
Antibiotic treatment of acute bronchitis in smokers: a systematic review. J Gen Intern Med.
2002;17(3):230–234.

9. Wilson AA,
Crane LA,
Barrett PH,
Gonzales R.
Public beliefs and use of antibiotics for acute respiratory illness. J Gen Intern Med.
1999;14(11):658–662.

10. Coco A,
Mainous AG.
Relation of time spent in an encounter with the use of antibiotics in pediatric office visits for viral respiratory infections. Arch Pediatr Adolesc Med.
2005;159(12):1145–1149.

11. Linder JA,
Singer DE,
Stafford RS.
Association between antibiotic prescribing and visit duration in adults with upper respiratory tract infections. Clin Ther.
2003;25(9):2419–2430.

12. Braman SS.
Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines. Chest.
2006;129(1 suppl):95S–103S.

13. Smucny JJ,
Becker LA,
Glazier RH,
McIsaac W.
Are antibiotics effective treatment for acute bronchitis? A meta-analysis. J Fam Pract.
1998;47(6):453–460.

14. Evans AT,
Husain S,
Durairaj L,
Sadowski LS,
Charles-Damte M,
Wang Y.
Azithromycin for acute bronchitis: a randomised, double-blind, controlled trial. Lancet.
2002;359(9318):1648–1654.

15. Petersen I,
Johnson AM,
Islam A,
Duckworth G,
Livermore DM,
Hayward AC.
Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database. BMJ.
2007;335(7627):982.

16. Christ-Crain M,
Jaccard-Stolz D,
Bingisser R,

et al.
Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet.
2004;363(9409):600–607.

17. Christ-Crain M,
Stolz D,
Bingisser R,

et al.
Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med.
2006;174(1):84–93.

18. Cals JW,
Butler CC,
Hopstaken RM,
Hood K,
Dinant GJ.
Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial. BMJ.
2009;338:b1374.

19. Paul IM,
Yoder KE,
Crowell KR,

et al.
Effect of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents. Pediatrics.
2004;114(1):e85–e90.

20. Use of codeine- and dextromethorphan-containing cough remedies in children.
American Academy of Pediatrics. Committee on Drugs. Pediatrics.
1997;99(6):918–920.

21. Lokker N,
Sanders L,
Perrin EM,

et al.
Parental misinterpretations of over-the-counter pediatric cough and cold medication labels. Pediatrics.
2009;123(6):1464–1471.

22. Schroeder K,
Fahey T.
Over-the-counter medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev.
2004;(4):CD001831.

23. Smucny J,
Flynn C,
Becker L,
Glazier R.
Beta2-agonists for acute bronchitis. Cochrane Database Syst Rev.
2004; (1):CD001726.

24. McKean M,
Ducharme F.
Inhaled steroids for episodic viral wheeze of childhood. Cochrane Database Syst Rev.
2000;(2):CD001107.

25. Yale SH,
Liu K.
Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med.
2004;164(11):1237–1241.

26. Timmer A,
Günther J,
Rücker G,
Motschall E,
Antes G,
Kern WV.
Pelargonium sidoides extract for acute respiratory tract infections. Cochrane Database Syst Rev.
2008;(3):CD006323.

27. Chuchalin AG,
Berman B,
Lehmacher W.
Treatment of acute bronchitis in adults with a pelargonium sidoides preparation (EPs 7630): a randomized, double-blind, placebo-controlled trial. Explore (NY).
2005;1(6):437–445.

28. Matthys H,
Eisebitt R,
Seith B,
Heger M.
Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis. A randomised, doubleblind, placebo-controlled trial. Phytomedicine.
2003;10(suppl 4):7–17.

29. Paul IM,
Beiler J,
McMonagle A,
Shaffer ML,
Duda L,
Berlin CM Jr.
Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med.
2007;161(12):1140–1146.

30. Phillips TG,
Hickner J.
Calling acute bronchitis a chest cold may improve patient satisfaction with appropriate antibiotic use. J Am Board Fam Pract.
2005;18(6):459–463.

31. Couchman GR,
Rascoe TG,
Forjuoh SN.
Back-up antibiotic prescriptions for common respiratory symptoms. Patient satisfaction and fill rates. J Fam Pract.
2000;49(10):907–913.

32. Macfarlane J,
Holmes W,
Gard P,
Thornhill D,
Macfarlane R,
Hubbard R.
Reducing antibiotic use for acute bronchitis in primary care: blinded, randomised controlled trial of patient information leaflet. BMJ.
2002;324(7329):91–94.

Inhaled corticosteroids for adults with cough lasting over three weeks

Background

There is often no obvious cause for coughs that last more than three weeks. Lack of a clear cause makes the cough difficult to treat. Current guidelines recommend that in many cases people with cough lasting longer than three weeks be given inhaled corticosteroids (ICS), which are commonly used to treat asthma and other diseases involving airway inflammation.

Review question

We wanted to find out if taking inhaled steroids in adults with cough lasting three weeks or longer were beneficial.

We looked at evidence from clinical trials. We analysed the effects of ICS compared with placebo on cough severity, lung function, complications of cough and airway inflammation, as well as the safety of this treatment.

Study characteristics

We found eight studies on 570 people with cough lasting over three weeks. Studies included different types of participants in terms of age, duration of coughing and risk factors for cough. Studies also varied in types of ICS, doses, treatment lengths and types of inhaler used. Cough severity was measured using different scales.

Key results

We looked at the proportion of people who were clinically cured or showed a significant improvement in cough severity as our primary outcome, but the data were too mixed to be able draw any conclusions. These differences between studies also prevented meaningful pooling of study results for proportion of people showing improvement in cough and average improvement in one specific type of cough scale. There was low quality evidence that ICS reduced cough severity score. There was not enough data about changes in pulmonary function, complications of cough and markers of inflammation to allow pooling of results.There was evidence of moderate quality that ICS treatment did not increase the risk of adverse events.

Conclusion and future work

This review has shown that the effects of ICS for subacute and chronic cough are inconsistent. Further studies with more consistent patient populations, interventions, outcome measures and reporting are needed to determine whether ICS help subacute and chronic cough in adults.

This Cochrane plain language summary was written in December 2012.

Asthma medications: Know your options

Asthma medications: Know your options

Confused about your asthma medications? Here’s what you need to know to sort out the main classes and numerous subtypes of asthma drugs.

By Mayo Clinic Staff

The types and doses of asthma medications you need depend on your age, your symptoms, the severity of your asthma and medication side effects.

Because your asthma can change over time, work closely with your doctor to track your symptoms and adjust your asthma medications, if needed.

Types of asthma medications

Long-term control medications

Many people with asthma need to take long-term control medications daily, even when they don’t have symptoms. There are several types of long-term control medications, including the following.

Inhaled corticosteroids

These anti-inflammatory drugs are the most effective and commonly used long-term control medications for asthma. They reduce swelling and tightening in your airways. You may need to use these medications for several months before you get their maximum benefit.

Inhaled corticosteroids include:

• Fluticasone (Flovent HFA)
• Budesonide (Pulmicort Flexhaler)
• Mometasone (Asmanex Twisthaler)
• Beclomethasone (Qvar RediHaler)
• Ciclesonide (Alvesco)

In children, long-term use of inhaled corticosteroids can delay growth slightly, but the benefits of using these medications to maintain good asthma control generally outweigh the risks. Regular use of inhaled corticosteroids helps keep asthma attacks and other problems linked to poorly controlled asthma in check.

Inhaled corticosteroids don’t generally cause serious side effects. When side effects occur, they can include mouth and throat irritation and oral yeast infections. If you’re using a metered dose inhaler, use a spacer and rinse your mouth with water after each use to reduce the amount of drug remaining in your mouth.

Leukotriene modifiers

These medications block the effects of leukotrienes, immune system chemicals that cause asthma symptoms. Leukotriene modifiers can help prevent symptoms for up to 24 hours. Examples include:

• Montelukast (Singulair)
• Zafirlukast (Accolate)
• Zileuton (Zyflo)

In rare cases, montelukast is linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. See your doctor right away if you have any unusual reactions.

Long-acting beta agonists (LABAs)

These bronchodilator (brong-koh-DIE-lay-tur) medications open airways and reduce swelling for at least 12 hours. They’re used on a regular schedule to control moderate to severe asthma and to prevent nighttime symptoms. Although they’re effective, they’ve been linked to severe asthma attacks. For this reason, LABAs are taken only in combination with an inhaled corticosteroid.

The most commonly used LABA for asthma is salmeterol (Serevent).

Theophylline

You take this bronchodilator daily in pill form to treat mild asthma. Theophylline (Theo-24, others) relaxes the airways and decreases the lungs’ response to irritants. It can be helpful for nighttime asthma symptoms. You might need regular blood tests to make sure you’re getting the correct dose. Potential side effects of theophylline include insomnia and gastroesophageal reflux.

Combination inhalers: Corticosteroids and long-acting beta agonists

Some inhaled asthma medication combinations contain both a corticosteroid and a bronchodilator:

• Fluticasone and salmeterol (Advair Diskus)
• Budesonide and formoterol (Symbicort)
• Mometasone and formoterol (Dulera)
• Fluticasone and vilanterol (Breo)

Quick-relief medications

These asthma medications open the lungs by relaxing airway muscles. Often called rescue medications, they can ease worsening symptoms or stop an asthma attack in progress. They begin working within minutes and are effective for four to six hours. They’re not for daily use.

Some people use a quick-relief inhaler before exercise to help prevent shortness of breath and other asthma symptoms. Possible side effects include jitteriness and palpitations.

Quick-relief medications include:

• Albuterol (ProAir HFA, Ventolin HFA, others)
• Levalbuterol (Xopenex HFA)

If your symptoms are minor and infrequent or if you have exercise-induced asthma, you might manage your symptoms with one of these medications alone. However, most people with persistent asthma also need an inhaled corticosteroid or other long-term control medication.

If you need to use your inhaler more often than your doctor recommends, your asthma is not under control — and you may be increasing your risk of a serious asthma attack.

Ipratropium

Ipratropium (Atrovent HFA) is a short-acting bronchodilator that’s usually prescribed for emphysema or chronic bronchitis, but is sometimes used to treat asthma attacks. It may be used either with or as an alternative to short-acting beta agonists.

Oral corticosteroids for serious asthma attacks

These medications may be taken to treat severe asthma attacks. They can cause bothersome short-term side effects and more-serious side effects if they’re taken for a long period. Examples include:

• Prednisone
• Methylprednisolone

Long-term use of these medications can cause side effects including cataracts, thinning bones (osteoporosis), muscle weakness, decreased resistance to infection, high blood pressure and reduced growth in children.

Medications for asthma triggered by allergies

Medications that focus on treating allergy triggers include:

• Allergy shots. Allergy shots (immunotherapy) may be an option if you have allergic asthma that can’t be controlled by avoiding triggers. You’ll begin with skin tests to determine which allergens trigger your asthma symptoms. Then you’ll get a series of injections containing small doses of those allergens.

  You generally receive injections once a week for a few months, and then once a month for three to five years. In some cases, immunotherapy can be done more quickly. Over time, you should lose your sensitivity to the allergens.

• Allergy medications. These include oral and nasal spray antihistamines and decongestants, as well as corticosteroid and cromolyn nasal sprays. Allergy medications are available over-the-counter and in prescription form. They can help with allergic rhinitis but aren’t substitutes for asthma medications.

  Corticosteroid nasal spray helps reduce inflammation without causing the rebound effect sometimes caused by nonprescription sprays. Because it has few, if any, side effects, cromolyn is safe to use over long periods of time.

Biologics

Your doctor may recommend treatment with biologics if you have severe asthma with symptoms not easily managed by control medications.

• Omalizumab. Omalizumab (Xolair) is sometimes used to treat asthma triggered by airborne allergens. If you have allergies, your immune system produces allergy-causing antibodies to attack substances that generally cause no harm, such as pollen, dust mites and pet dander. Omalizumab blocks the action of these antibodies, reducing the immune system reaction that causes allergy and asthma symptoms.

  Omalizumab is given by injection every two to four weeks. It isn’t generally recommended for children under 12. In rare cases, this medication has triggered a life-threatening allergic reaction (anaphylaxis). In addition, the FDA has issued a warning about a slightly increased risk of heart and brain blood vessel problems while taking this drug.

  Anyone who gets an injection of this drug should be monitored closely by health professionals in case of a severe reaction.

A newer class of biologic drugs has been developed to target specific substances secreted by certain immune system cells. For some people, certain white blood cells, called eosinophils, build up within body tissues. Eosinophils secrete substances, called cytokines, which cause inflammation. These biological drugs target eosinophils and cytokines, reducing their numbers within the body and lowering inflammation. Taken together with other asthma medications, biologics help people with more severe forms of asthma achieve greater symptom control. These medications include:

• Mepolizumab (Nucala)
• Benralizumab (Fasenra)
• Reslizumab (Cinqair)

Making the most of your asthma medications

Tracking symptoms and side effects and adjusting your treatment accordingly is key to keeping your asthma symptoms under control. With your doctor or other health care providers, write a detailed plan for taking long-term control medications and for managing an asthma attack. Then follow your plan.

Know when to adjust your medications, when to see your doctor and how to recognize an asthma emergency. If your doctor has prescribed a peak flow meter to measure how well your lungs are working, use it according to your plan. Even if you feel well, take your medications as prescribed and track your symptoms until you talk to your doctor.

June 19, 2020

Show references

1. Fanta C, et al. Treatment of intermittent and mild persistent asthma in adolescents and adults. https://www.uptodate.com/contents/search. Accessed Aug. 7, 2018.
2. Peters S, et al. Treatment of moderate persistent asthma in adolescents and adults. https://www.uptodate.com/contents/search. Accessed Aug. 7, 2018.
3. McPherson RA, et al., eds. Toxicology and therapeutic drug monitoring. In: Henry’s Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St. Louis, Mo.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Aug. 7, 2018.
4. AAAAI Allergy and Asthma Drug Guide. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/drug-guide. Accessed Aug. 7, 2018.
5. Asthma. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/print/4896. Accessed Aug. 7, 2018.
6. McCracken J, et al. Biologic therapy in the management of asthma. Current Opinion in Allergy and Clinical Immunology. 2016;16:375. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405559/. Accessed Sept. 4, 2018.

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Types, Side Effects & Usage

What should I know about medications for chronic obstructive pulmonary disease (COPD)?

You have the right and responsibility to know what medications are being prescribed for you. The more you know about your medications and how they work, the easier it will be for you to control your symptoms.

You and your healthcare provider are partners in developing an effective medication plan. Make sure that you understand and share the same treatment goals as your provider. Talk about what you expect from medications so you can know if your treatment plan is working.

The type and dose of medications you need might change with the season, your location or different triggers. These might include viral infections, allergens, pollution, cold air and exercise. For most people with COPD, it takes weeks to months to find a treatment plan that provides excellent symptom control.

What types of medications are prescribed for COPD?

If you have COPD, you may have more than one type of medication. Different types of medications work in different ways to help treat different symptoms. Also, you might have different ways of taking your medications. You might get tablets or you might have inhalers or nebulizers that will let you breathe in your medications. Here are some kinds of COPD medications:

Bronchodilators

Bronchodilators relax the bands of muscle that have tightened around the airways. This action opens the airways, letting more air in and out of the lungs, and improving breathing. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can therefore be coughed out more easily.

Broncho­dilators, such as beta2-agonists and anticholinergics, have different mechanisms of action, but both loosen muscle tightness and help to remove mucus through coughing. There are long-acting bronchodilators and short-acting bronchodilators.

Long-acting bronchodilators take a longer time to start helping you, but their effects last 12 to 24 hours. These long-acting medicines are also called maintenance or controller medications. The short-acting bronchodilators, often called rescue or reliever medications, start working within minutes but only last four to six hours.

Anti-inflammatory medications

Anti-inflammatories reduce swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers. Though some may give some relief quickly, others may need to be taken daily for several weeks before they will begin to fully control symptoms. Anti-inflammatories lead to fewer symptoms, better airflow, less-sensitive airways, and less airway damage.

Corticosteroids are the most commonly used type of anti-inflammatory medicines that treat COPD. Steroids come as both pills and inhalers. The pills are mostly used for times when you are having a COPD exacerbation, or when it is getting worse, because they can work more quickly. Inhaled steroids are primarily used in combination with other medications and are used over time to help control symptoms.

Leukotriene modifiers are another class of drugs that affect muscle tightness and may decrease inflammation. Leukotrienes are chemicals that occur naturally in our bodies that cause airway muscles to tighten up and increase the production of mucus and fluid. Leukotriene modifiers, used primarily for asthma, work by blocking the chemicals and decreasing these reactions. These medications can also help improve airflow and reduce symptoms in some people with COPD.

Combination medications for COPD

Your doctor might suggest a combination medicine to treat your COPD. These drugs usually combine different kinds of bronchodilator medications or pair a steroid with a bronchodilator. Each drug in the combination works in their own way to manage COPD symptoms to give you better control over the disease. Combination medications for COPD are generally available as an inhaler.

Other medications for COPD

Antihistamines relieve stuffy heads, watery eyes, and sneezing by drying up secretions. Although effective at relieving these symptoms, antihistamines can dry the air passages too much, making breathing difficult, as well as causing difficulty coughing up excess mucus. Take these medications with food to reduce upset stomach if needed.

Antibiotics might be prescribed to treat infections or help you recover from an illness. To help clear up your infection completely or to help you recover more quickly from an illness, it is important to take antibiotics for the full time of treatment, even if your symptoms have improved.

Expectorants help hydrate the airways, which helps thin mucus so it can be coughed out more easily. Take these medications with at least 8 ounces of water, and drink water regularly to help break up the mucus.

Antivirals might be prescribed to treat or prevent illnesses caused by viruses, most frequently to treat or prevent influenza (“the flu”). Influenza is particularly dangerous for people who have COPD.

Vaccines are important to prevent infections, especially flu shots and pneumococcal pneumonia shots. You need to get a flu shot every autumn, but the pneumonia vaccine is needed only once after age 65. If you got one before the age of 65, you would need to get another one after the age of 65, but at least 5 years after the first.

A note from Cleveland Clinic

COPD medications are used to improve your symptoms, but they cannot cure COPD. You’ll probably need to take more than one type of medication. These medicines are generally safe, but if you have side effects that concern you, talk to your healthcare team or pharmacist. It is a good idea to keep a list of the medications with you all of the time, either on a wallet card or a special app for your phone. Treating COPD is likely to involve a combination of therapies that may go beyond medications. For instance, your provider might prescribe oxygen if your lungs aren’t working well enough to get oxygen into your blood or they might ask you to consider pulmonary rehabilitation.

Inhaled Asthma Medications | AAAAI

If you suffer from asthma, you know what it feels like to gasp for air or feel tightness in your chest. The goal of asthma medications is to prevent symptoms like these from happening.

There are two general classes of asthma medications: quick-relief and long-term/controller control medications. Many inhaled asthma medications are meant to be used daily to keep your airways healthy, even if you are not experiencing symptoms.

With inhaled medications, the medicine is delivered directly to your bronchial tubes, helping to open your airways. Also, these medicines have fewer side effects compared to others that are taken by mouth or by injection.

Inhaled Medications

There are several asthma medications available in inhaled form. Your allergist / immunologist, often referred to as an allergist, is the best qualified to determine which is right for you.

Inhaled corticosteroids, also referred to as topical corticosteroids or glucocorticosteroids, are anti-inflammatory medications that have been used successfully to treat asthma for over 50 years. These types of steroids are very different from the ones misused by some athletes to help their performance. These asthma medications reduce many forms of airway inflammation, which helps normalize how much mucus you produce, airway hypersensitivity, swelling and tightening of your bronchial tubes.

Your asthma management plan may include taking inhaled corticosteroids even when you feel well. This is because the medications can prevent you from having an asthma flare-up or prevent your symptoms from becoming worse.

Examples of inhaled corticosteroids are beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone and triamcinolone. It is important to rinse with water and spit after each dose of inhaled steroids.

Bronchodilators are non-steroid medications that help open up your airways by relaxing small muscles that tighten them. Some bronchodilators are rapid-acting, and some are long-acting. The rapid-acting bronchodilators are used as “rescue” or quick – relief medications to immediately relieve your asthma symptoms, and include albuterol, levalbuterol, terbutaline and ipratropium. Although they make you feel better and breathe easier in the short – term, these drugs commonly do not solve the underlying problems that lead your asthma symptoms to appear.

If you regularly need these rescue medications more than two times per week, your asthma isn’t being properly controlled or there is something else going on that is causing your airways to be blocked. See your allergist to change your treatment.

Long-acting bronchodilators are used to provide asthma control instead of quick relief of asthma symptoms. They should only be used in conjunction with inhaled steroids for long-term control of asthma symptoms. These medications include salmeterol and formoterol.

Salmeterol and formoterol are long-acting beta 2-agonist bronchodilators with an anti-inflammatory medication on a regular (daily), rather than as-needed, basis. Each of these long-acting bronchodilators is available in combination with a corticosteroid within one inhaler.

Finally, tiotropium is an example of an inhaled long acting anticholinergic medication that is sometimes used as add-on therapy to improve asthma control and prevent asthma symptoms in both children and adults.

Types of Inhalation Devices – Asthma Inhalers

There are three basic types of devices that deliver inhaled medications. The most common is the metered – dose inhaler (MDI), which uses a chemical propellant to push the medication out of the inhaler. Nebulizers deliver fine liquid mists of medication through a tube or a “mask” that fits over the nose and mouth, using air or oxygen under pressure. Dry powder inhalers (DPIs) deliver medication without using chemical propellants, but they require a strong and fast inhalation.

No matter which you use, getting the medication to your lower airways is essential for the medication to work. For all devices, education and training on how to correctly use them is very important.

A device called a spacer may be prescribed if you’re having trouble getting the medicine to your airways with an MDI. Spacers help you coordinate your inhaled breath with the release of the medication from the MDI canister. With many MDIs, the spacer also makes the medication droplets smaller, so they can more easily get into your lower airways where they are needed. There are also MDIs with built-in spacers.

Using a dry powder inhaler is very different than an MDI. A lever may need to be pressed, a button squeezed, a cap removed or a dial twisted before inhalation. Dry powder inhalers need a stronger, faster inhalation and are not used with spacers.

Nebulizers

Nebulizers deliver asthma medications in a fine mist through mouthpieces or masks. You can breathe normally and there is no special coordination required. Nebulizers are useful for young children and some patients with more severe or acute asthma who are unable to use an MDI or DPI. Using a nebulizer can be more time-consuming, and may take five to 15 minutes for a treatment.

Healthy Tips

• Many inhaled asthma medications are meant to be used daily to keep your airways healthy, even if you are not experiencing symptoms.

• There are several types of inhaled asthma medications and your allergist can prescribe the right one for you.

• Metered – dose inhalers, dry powder inhalers and nebulizers are all types of devices that are used to dispense inhaled medicines. Each is used in a different way.

• No matter which device you use, make sure you know how to use it correctly, so that the medicine works and your asthma is under control.

The AAAAI’s Find an Allergist / Immunologist service is a trusted resource to help you find a specialist close to home.

Find out more about asthma.

This article has been reviewed by Andrew Moore, MD, FAAAAI

Reviewed: 9/28/20

Inhalers for bronchial asthma: what are there, how they work and with what drugs are used

Read this article:

Asthma attacks are accompanied by acute respiratory failure and require immediate relief. Inhalation therapy helps to eliminate respiratory spasm, get rid of suffocation and normalize well-being. Unlike pills and injections, it acts as quickly as possible, delivering the medicine directly to the bronchi.Which inhaler to choose and how to use it correctly? In this article, you will find an overview of inhalers and medications for asthmatics.

Advantages and disadvantages of various inhalers

1. Nebulizer

One of the most effective options for home use. The nebulizer can be compressor (converts the medicine into an aerosol with a stream of air) or with mesh technology (forms an aerosol due to the high-frequency vibration of the mesh-membrane).

It is convenient to use such a device for prophylaxis and basic treatment.

A separate type of nebulizer is portable. It runs on batteries or rechargeable batteries. Their disadvantage is their relatively high cost.

2. Liquid Inhaler

This is a compact dispenser bottle that you can always carry with you. Liquid inhalers have an affordable price and small size. You can always keep them close at hand. True, you need to use them correctly. Firstly, the medicine enters the respiratory tract only on inhalation, which means that you must simultaneously press the bottle and inhale the dose. Secondly, the active substance can cause adverse reactions, therefore, after inhalation, you should thoroughly rinse your mouth.

3. Spacer

The spacer is more likely not an inhaler, but an auxiliary device for inhalers with a dispenser, however, it should be singled out as a separate group. This intermediate container helps to conserve medication and is best suited for treating children who have difficulty controlling their breathing.Even if the baby did not breathe when pressing the bottle, you can be sure that the right dose will enter the respiratory tract. The minus of the spacer is the large size. It is not very convenient to take it with you on the road, while walking or traveling.

4. Powder aerosol

This inhaler does not require simultaneous pressing and inhalation. The medicine in powder form does not settle in the oral cavity. In this case, the inhalation must be strong enough, which makes powder inhalers not applicable to the elderly. Another drawback is the high price.

5. Hormone inhaler

This device operates on the basis of a broad-spectrum steroidal substance. A hormonal inhaler should only be used as directed by a physician in the event that more gentle therapy has not yielded results. The downside is strong side effects and negative effects on metabolism.

Preparations for the inhaler: an overview of the most popular medicines

In the treatment of bronchial asthma, drugs with a varied spectrum of action are used: from basic therapy to relieving acute attacks.The most popular are the following:

• Sympathomimetics (Terbutaline, Salbutamol, Pirburetol, etc.) – expand the bronchi and stimulate their work.
• Blockers of the M-cholinergic receptor group (for example, Atrovent) – relax the bronchi.
• Methylxanthine group (for example, Theophylline) – eliminate bronchospasm by relaxing the smooth muscles of the bronchi.

In addition, the doctor may prescribe inhalations with Lazolvan, Berodual or Magnesium sulfate.For children and people with drug intolerance, saline is used as a substance for inhalation.

When inhalation is contraindicated

Inhalation treatment is not always possible. True, in this case we are not talking about individual types of devices, but about medicines that need to be inhaled. You will have to refuse such therapy if there are a number of contraindications:

• Coughing up blood (pulmonary hemorrhage) and serious lung diseases (emphysema and pneumothorax).
• Diseases of the heart and blood vessels, high blood pressure.
• Individual intolerance to certain substances.
• Recently suffered a stroke or heart attack.

When choosing a medicine for the treatment and prevention of asthma attacks, you should consult your doctor. Only a specialist can choose the right drug and a competent treatment regimen.

In conclusion, it is worth noting that it is important not only to get the right inhaler, but also to learn how to use it correctly.

Be sure to read the instructions for the nebulizers. In the case of an inhaler with a dispenser, special skill is required (you need to inhale the drug at the moment you press the bottle). If the chosen treatment does not relieve symptoms and does not improve the quality of life, it is necessary to consult a doctor again to make adjustments.

Asthma Inhaler – Chemical Composition and Types of Inhalers

What are the asthma inhalers? Inhaler types.

If you are an asthmatic, you need at least one and possibly two different types of asthma inhalers. Usually, those who have experienced asthma use two types of inhalers. Asthma inhalers differ in the chemical composition contained in them.

The formulation of the asthma inhaler does not actually convey the essence of the drug – they contain propellants, as well as stabilizing compounds in small amounts. Propellants used to contain chlorofluorocarbons (CFCs), but due to concerns about their damaging effects on the ozone layer, they were replaced by hydrofluoroalkanes (HFAs) in the 1990s.This replacement had an unexpected positive effect, including for budesonide, it reduced the size of liquid particles in the mist produced by nebulization of the inhaler. This fact alone caused an increase in the effectiveness of the drug budesonide by 2.6 times.

Roughly speaking, asthma medications can be divided into two types: supportive and protective. The purpose of each is fairly obvious: adjuvants are used to relieve asthma symptoms when they occur, while asthma inhalers are used to prevent symptoms early.The chemistry of different types of asthma inhalers differs depending on which of the two results you want to achieve.

Asthma auxiliary inhaler. Chemical composition and action

Salbutamol (known as albuterol in the United States) is the main chemistry used in asthma adjuvant inhalers. This compound is known as a bronchodilator. Salbutamol and other similar compounds work by stimulating receptors in the muscles of the airways, causing them to relax and expand, and provide relief from asthma symptoms.It is these inhalers that asthmatics use in case of an asthma attack. An asthma inhaler, by spraying the liquid it contains, turns it into a very fine mist that can be inhaled. Thanks to this mist, the chemical composition of the asthma inhaler effectively affects the muscles in the lungs.

Asthma inhalers of auxiliary action, if necessary, act quickly, the effect is achieved within 5-20 minutes after ingestion, and lasts up to two hours. They also provide more or less immediate relief from asthma symptoms.However, asthma relief inhalers do not protect against future symptoms. This requires a different chemical composition.

Safety inhaler for asthma. Chemical composition and action

Safety inhalers for asthma, as a rule, steroids, are often produced in the form of nebulizers, similar to auxiliary ones. One of the most common is Budesonide, often sold under the brand name Pulmicort; another commonly used is beclomethasone dipropionate.These steroid medications work by reducing inflammation in the lungs, helping to keep the airways open, and desensitizing the lung tissue to triggers. Unlike ancillary inhalers, asthma inhalers are not used to relieve asthma attacks; instead, regular dosing is needed to prevent symptoms.

It is usually necessary to use a safety asthma inhaler daily to see beneficial results after 8 days.In addition to this, it can take up to 6 weeks of treatment to achieve maximum effect. Even after the prophylactic effect is noticeable, it can quickly disappear if regular dosing is not maintained. For some patients, it is proposed to combine asthma inhalers, which perform both auxiliary and protective functions.

Active ingredients: Salbutamol and budesonide

The active ingredients salbutamol and budesonide are on the World Health Organization’s Essential Medicines List, which are defined as the most important medicines required for the basic health system.Budesonide actually also has another use, in the treatment of Crohn’s disease. Without any of these compounds, life for asthma sufferers would be much more difficult and potentially shorter!

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Inhaler for rhinitis and cough: types and rules of application

Using the inhaler for coughs and runny nose helps relieve nasal congestion, relieve dry cough and supplement general therapy with local effects. An integrated approach to treatment shortens the time of illness.

Action of inhalers for runny nose and cough

Inhalation is the method of introducing an active substance into the body through breathing. Natural inhalations occur when the surrounding air is saturated with beneficial substances.

Sea salt is breathed on the coast, in the pine forest there is an excess of coniferous phytoncides. Artificial inhalations are carried out using special devices, inhalers.

Procedures allow you to directly influence the focus of the disease by inhaling drugs.

A variety of inhalers

Inhalers capable of spraying ultra-small dispersed particles are called nebulizers, from the Latin nebula – cloud, fog. Finely dispersed substances penetrate deeply into the respiratory tract, allow the treatment of rhinitis, laryngitis, bronchial and pulmonary diseases. Inhalers transport drugs to the site of the disease.

The use of nebulizers for cough and runny nose is effective. Evenly sprayed drugs irrigate the respiratory system, relieving swelling, inflammation of the mucous membranes.Moisturizing the respiratory system facilitates the passage of phlegm, softens a hard, barking cough.

Treatment of the area near the focus of the disease localizes the inflammation, does not allow the infection to spread further. The risk of complications and relapses of the disease decreases.

Inhalers are divided into 4 categories according to the principle of drug substance formation:

• ultrasonic,
• steam,
• compressor rooms,
• electronic mesh.

When choosing an inhaler for a cold, pay attention to the operating time, the volume of the container, the position of the patient’s body during manipulation. Nebulizers form small particles that penetrate the bronchi and light particles, the active substance remains cold.

Ultrasonic devices

Ultrasonic nebulizers form a fine aerosol from medicinal particles.

The metal plate of the device’s emitter vibrates at an ultrasonic frequency, spraying the drug into small particles.The particle size varies in the range of 0.5-10 microns, the liquid cloud penetrates well into the middle and lower respiratory tract.

Suitable for ultrasonic spraying:

• saline solutions, mineral waters,
• salt solutions,
• dissolved essential oils,
• herbal decoctions.

The device is light, small in size, easy to carry. Battery power allows you to inhale not only at home, but also wherever it is convenient:

• in transit,
• at work,
• on vacation.

Silent work does not disturb the peace of old people, does not frighten children. A wide range of accessories includes masks and attachments that are convenient for performing the procedure while lying down or while sleeping.

Disadvantages of ultrasonic inhalers are:

• damage to drug molecules,
• low efficiency of conversion into aerosol of thick suspensions, viscous compositions.

The molecules of antibiotics and hormones destroyed by ultrasonic vibration do not have a therapeutic effect on the respiratory system, they are simply useless.Such groups of drugs are not sprayed with this category of inhalers.

Steam devices

Steam inhalers work according to the simplest principle. The medicine evaporates from the container when exposed to high temperatures. The device consists of an evaporator and a tube.

The steam containing the medicine additionally warms up a sore throat, has a moisturizing and softening effect. Steam temperature is regulated.

The device is useful for the treatment of dry cough, diseases of the larynx.Due to vasodilatation, capillary blood flow increases, local immune processes are activated.

Evaporators can easily handle water-based liquids with boiling points less than 100 degrees. The procedures can be combined with aromatherapy, use saline solutions, decoctions of medicinal herbs.

Modern devices are safe to use, the risk of burns is excluded.

The disadvantages of steam inhalers include a low concentration of a useful substance in a cloud of steam, the destruction of medicinal substances at high temperatures.

Compressor devices

Compressor type refers to nebulizers for cough and runny nose, in the work forms a fine aerosol. The medicinal substance is sprayed with a jet of compressed air from a compressor. The compressor and air create the characteristic noise that distinguishes compressor inhalers from other types. The device is capable of spraying all groups of drugs.

Due to their versatility, physiotherapy rooms of dispensaries and clinics are equipped with stationary compressor inhalers for cough and runny nose.The attachments of household appliances are the same for children and adults.

The devices are simple in design, safe in operation, and are sold at a reasonable price. The only drawback of compressor inhalers for cough and runny nose is the high noise level during operation.

Electronic mesh devices

Electronic nebulizers are a modern development. The drugs are sieved through a vibrating perforated plate. The mixture passing through the smallest openings of the mesh membrane forms a high-quality finely dispersed cloud of the healing aerosol.The dose of active substances is calculated very accurately, the consumption of drugs is reduced, and accidental overdose is completely excluded.

• mucolytic agents,
• hormonal preparations,
• antibacterial agents.

The device has no restrictions, it successfully irrigates the respiratory tract with herbal or saline solutions, mineral water. Using drugs without residue, you can significantly save. The patient can take the procedure in any position, the silent operating mode allows you to relax and calm down.Care consists in thorough and timely flushing of the membrane.

Electronic mesh inhalers for rhinitis and cough are an excellent choice for families with children. The only drawback of inhalers is the price, which is higher compared to other nebulizers.

Recommendations for the use of inhalers

Correct use of inhalers is the key to the maximum therapeutic effect of inhalation for the treatment of cough and runny nose. During the procedure, you need to focus on breathing, without being distracted, breathe in and out smoothly and measuredly.

• in the treatment of cough – inhale through the mouth, exhale through the nose,
• for rhinitis therapy – inhale through the nose, exhale through the mouth.

After the treatment procedure, rest is observed for two hours, physical activity and walks in the fresh air are excluded during this time. Inhalation before bedtime is especially useful, after eating a pause of 1-1.5 hours is maintained.

Competent selection of drugs is carried out only by a doctor. Ready-made solutions are sold in pharmacies in a single dose, the package is called nebula.Before use, carefully read the annotation to the medicine.

Mixing the solution on your own, combine 2 ml of active ingredient with saline. It is not recommended to dilute the drug with distilled water; in some cases, water increases cough and runny nose.

Saline is left sterile by drawing up and pouring into the inhaler using a syringe. The cold solution is kept to room temperature.

The remains of the mixture after handling are discarded, reuse is prohibited.

Before using the device for the first time, read the instructions.

When treating with inhalers for rhinitis and cough, it is strictly prohibited:

• an hour before and after the procedure to smoke, drink alcoholic beverages,
• use antiseptics to treat the oral cavity before inhalation.

Duration of procedure for children

The principle of inhalation is explained to children, they are occupied with a cartoon or a fairy tale. The child is forbidden to talk.The procedure time for children under 5 years old is limited to three minutes, at the age of 5-14 years the time increases to 5 minutes, from 14 years old the procedure time is brought to 10-15 minutes. The drugs are used only as directed by a doctor.

Contraindications for inhalation

Like all medical procedures, the use of an inhaler for a runny nose and cough has contraindications. Such factors can be symptoms of incompatible diseases, allergic reactions, the patient’s age. Carrying out procedures that are not suitable for the patient causes serious harm to health and leads to complications.

Contraindications for inhalation:

• children up to one year old,
• otitis media, sore throats of a bacterial nature,
• intolerance to the active drug,
• blood, ichor in sputum,
• allergic rhinitis,
• increased body temperature, fever, fever,
• low-grade fever, severe heart disease,
• tendency to nosebleeds.

In all these cases, the use of inhalers is prohibited.

Related video: How to do inhalation with saline for coughs and runny nose

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Treatment of cough and runny nose with an inhaler

With the beginning of autumn, adults and children have a significant increase in the risk of encountering various pathologies of the respiratory system. Cough and runny nose are constant companions of many of them.

Drug treatment with strong drugs is not always justified, especially for small patients. Physiotherapy is considered a more gentle, but no less effective method.

An effective and safe device – an inhaler for coughs and runny nose – will help to get rid of such unloved symptoms. But for the treatment to bring relief, you need to find one that will meet all the requirements.

Which device to choose

There are only two large groups of such devices:

• steam inhalers;
• nebulizers, subdivided into compressor, ultrasonic, electronic mesh.

If from the name of the former it is clear that the treatment in this case is carried out with steam with rather large particles of water, then the latter transform the medicinal solution into a high-quality finely dispersed aerosol.

Steam inhaler for children from coughs and runny nose will only relieve colds.

Nebulizers, on the other hand, are able to provide the required effect even with pathologies of the lower respiratory tract and with allergies.

In order to choose the necessary device and not regret buying, it is better to first understand their types, advantages and disadvantages well. Studying the rating of inhalers will help you navigate the list of the most worthy applicants, find the best option for yourself.

Steam inhalers

Examples: Bremed BD7100, B. Well WN-118, Gezatone 105S.

The principle of operation of these devices is no different from the operation of the usual childhood procedures carried out over a pot of hot water, under a towel.

Inhaled vapors of drugs dilute phlegm, which means they make it easier to cough up.

For adults, such inhalers are quite suitable, but the high temperature of the steam can cause significant damage to the child’s respiratory tract, along the way making the cough more severe.

The most significant disadvantage of steam inhalers is the low concentration of nutrients, which does not allow achieving the desired therapeutic effect.

Only those drugs that have a boiling point of less than 100 ° C – essential oils – are effective during the procedure. Another drawback is the impossibility of using them at high body temperatures.

Steam inhalers produce an aerosol with a fairly large particle size (5 to 10 microns). This prevents them from reaching the lower respiratory tract – alveoli, bronchi, trachea.

Compressor nebulizers

Examples: B. Well WN-115K, B. Well WN-117, OMRON CompAir NE-C28.

The device consists of a compressor and a chamber with a preparation, they are connected by an air duct. The first produces a powerful stream of compressed air, which, reaching the compartment with the medicinal agent, breaks its composition into tiny particles. This allows you to inhale with benefit even a pair of medicinal herbs.

This type of inhaler is a universal nebulizer for children against coughs and runny nose, so they can be seen in various medical institutions.Omron devices are especially common. They are distinguished by their loud sound, the “omnivorousness” of various compositions, the use of a mask equally suitable for children and adults. In addition, compressor nebulizers are cheaper than other types of inhalers.

Ultrasonic nebulizers

Examples: B. Well WN-119U, LD-250U, Omron NE-U17.

In this type of inhaler, the working tool is an ultrasonic device – a metal emitter plate. By vibrating, it breaks the drug into small particles (less than 5 microns), ensures their rapid penetration into the lowest parts of the bronchi, which means that it increases the effectiveness of the drug.

The devices are distinguished by their high productivity. They are compact and quiet, run on batteries, so they are easy to take on the road.

Children’s ultrasonic inhalers for cough and runny nose are good in that you do not need to use masks or nozzles purchased separately. It is enough to place them by the bed for the effect to be ensured.

But the therapeutic effect with this method will decrease slightly. The downside is the impossibility of using antibiotics, hormones, mucolytics in these nebulizers due to their destruction.

Electronic mesh mesh nebulizers

Examples: B. Well WN-114, LD-207U, A&D UN-233.

In a relatively new type of inhaler, which is a type of ultrasonic device, the effect is achieved thanks to a fine mesh membrane.

It vibrates and sprays medicinal preparations, but does not destroy their structure. This feature allows for inhalation with antibacterial, hormonal and mucolytic agents.

Among the advantages is an accurate calculation of the medicine, so you can not be afraid of an overdose.

This cough inhaler for babies comes in the form of attractive toys, and the silent operation makes treatment an entertaining game. There is one minus, but it is big – this is a high price.

Despite this, its service life is long, so the device will definitely pay off.

It should be noted that when inhaled with infusions or decoctions, it is recommended to extremely thoroughly filter these liquids or refuse them altogether.

Rules of use and precautions

In order for the procedures to bear fruit quickly, and the device to serve for a long time, physiotherapy for cough at home must be carried out correctly:

1. Before using the inhaler in children, you need to discuss the dosage of the medication with the pediatrician.
2. At the slightest discomfort, inhalation stops.
3. The mask must correspond to the patient’s age. It is put on before turning on the inhaler.
4. The session is terminated if the medication has run out, which will be signaled by the device with a sound.
5. Clean the nebulizer according to the instructions after each use.

Sessions are carried out one hour before meals or 2-3 after meals. Brushing your teeth, drinking and eating immediately after the procedure is prohibited.The first close acquaintance with the inhaler should be short-lived (3-4 minutes). Then you can slightly increase the duration – by 2-3 minutes.

The elements of the device with which the patient was in contact need to be treated with antiseptics or boiling water. Once a month, all components of the inhaler require disinfection (boiling).

Solutions for inhalation

The required cough medicine is prescribed by your doctor. The age of the patient, the symptoms of the disease, its duration, the possibility of allergy to the components of the drug are taken into account.A variety of medications are used for physiotherapy.

Sodium chloride (0.9%) is used as the main liquid. Its presence makes it possible to obtain the required volume for inhalation – both for liquid preparations and for powders. The use of water, even distilled water, is prohibited.

Antiseptic

Used as antiseptics:

• Dioxidine (1%). Disinfects the respiratory system. For one procedure, measure 4 ml, dilute the drug with saline in a ratio of 1: 1.
• Miramistin. Used in the treatment of infectious diseases. It is especially effective if there is purulent discharge. For children under 12 years old, use 2 mg, diluted with saline in a 1: 2 ratio. At an older age and for adults, the dose increases to 4 ml, but the medicine is used in its pure form.
• Fluimucil antibiotic. Applied in parallel with other expectorant drugs. Up to 12 years old, 125 mg is prescribed, older and adults are allowed twice as much. Dilute the drug with 2 ml of saline.The number of daily inhalations is 1-2. Before inhalation, you need to take a bronchodilator.
• Furacilin. Helps in the treatment of acute respiratory viral infections, prevents the spread of pathology to the lower sections – to the lungs, bronchi, larynx. Use exclusively in pure form, 4 ml 1-2 times daily.

Immunomodulating

In this group of medicines:

• Interferon. Used to prevent colds and inflammations. It is recommended to be included in therapy at the first symptoms.Water (up to 2 ml) is added to the powder, diluted with 1 ml of saline.
• Derinat is a prophylactic drug during outbreaks of acute respiratory viral infections and influenza. 2 ml of Derinat is diluted with the same amount of base solution. Nebulizer procedures are performed twice a day.

Moisturizers

These are the necessary recipes for children for inhalation when coughing with a nebulizer, especially dry. It is recommended to inhale and exhale aerosols through the nose. For one session, take 3-4 ml of funds, regardless of the liquid.

Use saline, as well as any brand of alkaline mineral water – Narzan, Essentuki, Borjomi. Before the procedure, gases must be released from the bottle.

For thinning mucus and sputum

ACTS Inject, Fluimucil liquefy phlegm, which means they translate a cough into a productive one. Ambrobene, Lazolvan, this mucus is quickly removed from the respiratory tract. These drugs are diluted 1: 1 with saline. Children under the age of six are recommended 1-1.5 ml, over 2 ml.

Vasoconstrictor and decongestant

Used with care:

• Naphthyzine.It is used for allergic laryngeal edema, severe forms of laryngitis, and croup. For one session, take 3 ml, dilute it depending on the original preparation. At 0.05%, it is diluted with 5 ml of the stock solution, if 0.1%, then mixed with 10 ml of sodium chloride.
• Epinephrine can cause tachycardia, therefore it can be used for coughing only with the permission of a doctor. Up to two years, 0.25 ml is taken for a session, for older age – twice as much. The medicine is diluted with saline in a ratio of 1:12 and 1: 6, respectively.

Anti-inflammatory

These products usually contain alcohol-infused herbal extracts or bee products. They help with pathologies of the respiratory tract, relieve pain, help eliminate cough.

• Malavit. Belongs to the category of dietary supplements. The drug is mixed with saline in a ratio of 1:30, 3-4 ml is used for one procedure, three times a day.
• Propolis. The ratio is 1:20, the volume and number of daily procedures are similar to the use of the previous remedy.Contraindication – individual intolerance.
• Rotokan. You can use the product in combination with other medicines. Dilute Rotokan with saline in a ratio of 1:40, measure 4 ml for each procedure carried out three times a day.

Bronchodilators

Effective among bronchodilators:

• Atrovent. The drug relieves asthma attacks, but it is often used to prevent chronic lung pathologies. The dose for one inhalation depends on the age.Up to 6 years old, it is necessary to take 10 drops, from 6 to 12-20, for older ones – up to 40. For the required volume (3-4 ml), mix with saline.
• Berodual. Relieves bronchospasm in cases of dry, allergic cough. For children under 6 years old, 10 drops are measured, then by category – 20 to 12 years old, 40 if 12 years old or more. It is recommended to add 3 ml of saline.

When prescribing a complex of anti-cough drugs for an inhaler with a different effect, it is necessary to follow a certain scheme, this should always be done.First, they use procedures with bronchodilators, continue treatment with mucolytics, and complete the sessions with antimicrobial drugs.

How to choose the right cough inhaler?

The use of a cough inhaler has several obvious advantages over using regular syrup or tablets from a pharmacy.

This form of drug intake into the body ensures its delivery to the site of inflammation – directly to the most distant bronchi, even if the inflammation develops in the lower lobes of the lungs.

As it spreads, the medicinal vapor or aerosol fills the bronchial tree and produces an excellent therapeutic effect.

The time after which the drug begins to act also varies – with oral use, you have to wait until the agent is absorbed, and when inhaled, the particles of the substance settle directly on the mucous membrane and begin to act almost immediately.

But the correct use of the inhaler also needs to be learned, because you can inadvertently harm the patient, worsen the condition, delay the cure, or simply not achieve results.Also, be sure to consult with your doctor about dosages, frequency of administration and group of the drug in order to achieve maximum effect without undesirable consequences.

Types of cough inhalations

There are many types of inhalation, as this method has been used for a very long time. They differ in the method of delivery of the active substance, in the composition of this substance, as well as in the medicinal effects produced and the purpose of treatment. Each type has an optimal scenario according to which it is used correctly, as well as contraindications.

Most common inhalation methods:

• Steam inhalation – this procedure involves inhaling water vapor through the nose or mouth, while the inhaled liquid may contain a drug, essential oil, or traditional medicine. Thus, the vapors reach even the deepest layers of the lungs, and moisture and temperature help increase the secretion of phlegm, make it more productive, which is especially effective in combating dry cough. But this type of inhalation has contraindications and special rules for use, which must be taken into account before use.First of all, this method can be used not for all pathologies of the respiratory tract. You should also take a responsible approach to the choice of an active agent.
• Aerosol inhalation – this method does not consist in evaporation of a medicinal substance, but in its spraying into tiny particles (aerosol) and subsequent inhalation. This type of procedure cannot be performed in artisanal conditions – it is imperative that you have a special device – a nebulizer. It can be accessed at many pharmacies, hospitals and clinics, and a device for home use can also be freely purchased.They are of different types and characteristics, but using a nebulizer is extremely effective in case of respiratory tract disease – a drug is sprayed directly, which begins to act as soon as it enters the inflammation focus.
• Dry inhalation – with this type of inhalation, the patient does not inhale the vapor or small particles of the medicine, but the air with the medicine component. One of the most common methods of such treatment is a salt room in a hospital or sanatorium.Also, sometimes powdery substances are sprayed into the air, which are simply inhaled from the air in the room, without moisture.

Each of the above methods has its own advantages and disadvantages, as well as specific contraindications. It is necessary to figure out – which is the best cough inhaler?

Steam inhalers for cough and runny nose

Such treatment involves the use of a container of water, into which medicines or medicinal compounds are added, after which the steam emanating from the container is inhaled by the patient.Most often, to prepare such an inhaler, you will need a pot of hot water and a medicine, or an essential oil – there are many recipes. The benefits of treatment with such an inhaler are obvious:

• Easy to prepare and apply at home. You don’t need any special devices, just a container and boiling water. To do such an inhalation is extremely simple, it takes a little time.
• Expectorant effect – water vapor, penetrating into the lower respiratory tract, dilutes phlegm, which helps to reduce its viscosity and better excretion of mucus.
• No side effects – since the main ingredient is water, steam inhalation is harmless unless there are specific contraindications. Unlike the use of drugs, it is impossible to get an overdose or side effects for either children or adults.

General rules for the procedure: pour hot water into a container, add a few drops of essential oil (aloe, mint, cypress, cedar, pepper) and stir. Now you can inhale – take a deep breath through your nose and exhale through your mouth.

Thus, the solution should be inhaled for 1-2 minutes. It is better to breathe deeply, and the phlegm may begin to drain, causing a violent cough. If the complex treatment continues, the cough will become productive and will disappear over time.

Aerosol inhalers for cough

This type of inhalation is more modern, it allows you to directly spray the drug, which contributes to its excellent absorption. But for this you need a nebulizer – it’s great that the prices for these devices are more and more humane every year, so you can buy a nebulizer for aerosol inhalation in every home.

As for the types of spray, they are:

• Classic nebulizer, which sprays microparticles using mechanical blades – they are completely safe and are the best option for a cough inhaler for children, therefore, they occupy the first line in the ranking of purchasing devices of this type;
• Ultrasonic – under the influence of high frequency sound, the whole mass of liquid is broken into microparticles. Its disadvantage is that some drugs are destroyed by ultrasound;
• Compression – Compresses the medicine and throws it out through a narrow tube in a thin stream, which provides the spray effect.

To maximize the effect, follow the instructions for use of the nebulizer. After all, anything can be poured into the device. Below is a list of drugs that are commonly used everywhere:

• Alkaline solutions and mineral water – often seawater also falls into this category. The fact is that such solutions, even without an active substance, perfectly moisturize and relieve swelling, and therefore are used to help a patient with a runny nose.
• Bronchodilators are drugs used to expand the lumen of the bronchial tree. Often they are prescribed for asthma and chronic bronchial obstruction, but this is not the end of their use. Also, such funds are used for any disease that leads to respiratory failure due to bronchospasm. Even with bronchitis, this group of drugs will be appropriate. These include Ventolin, Berodual, Berotek, Salbutamol and others.
• Mucolytics – this group of drugs allows you to increase the synthesis of mucus in order to convert a dry cough into a wet one, as well as by breaking down chemical bonds inside the sputum to make it more liquid, fluid, easy to cough up.Together with the mucus, all pathogens, infectious agents and microorganisms stuck in it are excreted. This group includes Lazolvan, Ambroxol. But there is an important condition – you cannot use these expectorants at the same time as antitussives, this will lead to prolonged inflammation and long-term ineffective treatment.
• Antibacterial agents – after confirming the diagnosis of acute bronchitis, antibacterial therapy should be started immediately using antibiotics. They are most effective in combination therapy with all types of drugs.

• Consult a specialist before use.
• Nikita Baidukhov
• Even more interesting articles on our website b-apteka.ru

Inhaler for cough and runny nose – nebulizer for throat and nose for adults: what the breathing apparatus treats

Among the proposed methods of physiotherapeutic treatment, inhalations are in one of the first places, since this method is quite safe, unlike most medications, it affects the mucous membranes of the respiratory organs and has practically no contraindications and side effects.

Definition of symptoms

The very first symptoms of most acute respiratory infections and acute respiratory viral infections are cough and runny nose. Why is this happening?

The mucous membrane of the nose and throat is the main obstacle to the penetration of pathogens into our body. Every second we breathe in millions of viruses and bacteria, but most of them die when they get on the mucous membrane of the respiratory organs. Of course, with the normal functioning of the immune system.

Some part of the pathogenic microflora can adapt to living inside the human body and become conditionally pathogenic microorganisms that are activated under favorable conditions: weakening of the immune system, infection by external agents.

The main reason for the appearance of a cough and a runny nose is the attempts of the immune system to remove the destroyed microbes from the body as quickly as possible. Therefore, do not be alarmed when these symptoms appear – your body fights and fights successfully. But it is simply necessary to provide him with help. And one of the methods that are most effective in the very early stages of the disease is inhalation.

Early use of inhalation can significantly speed up the healing process by increasing the rate of passage of pathogenic mucus from both the respiratory system and the nasal passages.

At the same time, the main advantage of treatment methods remains – do no harm.

After all, inhalations, subject to the correct choice of medication and adherence to the rules of the procedure, do not have side effects and are allowed for all age groups.

Why inhalation is effective

The use of inhalations is justified not only in the early stages of diseases, but also during the period of rehabilitation therapy after bronchitis, with bronchial asthma, bronchiectasis, cystic fibrosis, infectious inflammation of the upper respiratory tract.

This widespread use is due to the high efficiency of procedures and the speed of recovery action. One of the types of natural inhalations is therapy with the inhalation of sea, mountain, pine air.

The effectiveness of this method lies in the deep penetration of the medicinal substance into the respiratory system and at the same time its uniform distribution. This ensures rapid absorption into the bloodstream and the manifestation of a healing effect in the shortest possible time.

It is not recommended to carry out inhalations with a tendency to nosebleeds, at t above + 38 ° C, with cardiovascular or respiratory failure, the presence of oncological diseases.

Types of inhalers

The modern market provides the consumer with a wide range of products for inhalation at home. There are two main types of inhalers, which differ in the principle of introducing the drug into the patient’s body: steam and nebulizers.

Nebulizers

The principle of action of nebulizers is based on the introduction of an aerosol of a sprayed medical preparation into the patient’s body.Depending on the method of nebulization, nebulizers are divided into several types, each of which has certain advantages and disadvantages:

• Ultrasonic. The principle of operation is based on the vibration of a special emitter plate, which allows the drug to be broken down when injected into particles no larger than 5 microns. This allows the therapeutic agent to reach the smallest bronchi. Thus, the effectiveness and speed of action is increased. The undoubted advantage is also noiselessness during operation.The main disadvantage of this type of device is the impossibility of using antibacterial agents, steroid hormones and mucolytics. Some of them are destroyed by ultrasound, while others cannot be split into small enough particles;
• Compressor rooms. The essence of the operation of this type of inhaler is the formation of an aerosol under the action of compressed air supplied to the nebulizer chamber under high pressure. To work with these inhalers, any solutions are allowed: oil, alcohol, water.Compressor inhalers can be used to treat infants and bedridden patients. As negative points, only larger dimensions can be noted in comparison with ultrasonic ones and noise during operation. Nevertheless, this type of inhaler is the most popular due to its versatility in use;
• Electronic mesh or mesh nebulizers. They are a kind of ultrasonic inhalers and differ from the latter in the principle of atomization. Ultrasonic vibrations are applied not to the medicine, but to the mesh-membrane.This avoids the destruction of the nebulant molecules. This improvement made it possible to use the apparatus for the use of a wide range of drugs, including antibiotics, mucolytics, hormonal agents. The only drawback of this type of nebulizer is the still high cost. When using homemade herbal infusions, thorough filtering is recommended to avoid clogging the mesh.

Each type of device has its own advantages, and when choosing which nebulizer for children it is better to consider, for what purpose you need an inhaler, for how long, the degree of its safety and reliability, as well as warranty obligations.

Steam

Modern steam inhalers are equipped with a mode of maintaining a certain temperature, which makes it possible to increase the degree of safety when using the devices. Ease of use is not its only advantage:

• Price availability;
• Possibility of using essential oils;
• Ideal for moisturizing mucous membranes with vapors.

The formation of a coarse aerosol (more than 5 microns) makes this type of device indispensable in the treatment of the upper respiratory tract (rhinitis, laryngitis, pharyngitis) and absolutely useless in lower diseases (bronchitis and tracheitis, pneumonia).

A significant disadvantage of steam inhalers is the increased danger during operation. That is why it is recommended to use a nebulizer with a high degree of safety in the treatment of children.

Another negative point in the operation of this type of inhaler is the destruction of medicinal components at high temperatures.

Before purchasing a steam inhaler, carefully read the instructions for use, consult your doctor and only then make a choice.

Dr. Komarovsky warns mothers about the seriousness of choosing an inhaler: use steam inhalers only to treat a cold, but a nebulizer with a cold can be harmful, since

Small particles of medication enter the lungs.

Drugs intended for the treatment of the common cold, when deposited in the lungs, can cause a lot of negative effects, and some of them will have serious consequences.

For example, when essential oils enter the lungs, mucus aggregates in the alveoli, which leads to inflammation – lipoid pneumonia.In the same way, lung pollution occurs when poorly strained herbal infusions are used. Only mesh nebulizers provide 100% protection.

An exception can be made by such safe products as saline or alkaline mineral water, which are a kind of analogs of sea air. Inhaling such drugs, even with healthy lungs, will not cause any harm.

Effective Prescriptions and Preparations

Carrying out inhalation, especially when treating children, requires knowledge of some rules in the conduct of procedures and the use of certain drugs.

From a cold

As already mentioned, it is recommended to use only a steam inhaler in case of a cold. However, at high temperatures, the medicinal properties of most drugs are destroyed, and some of them do not evaporate at all. That is why the following drugs are used for a cold:

• Essential oils. They have the ability to evaporate quickly, much faster than water, but moisturize the mucous membrane much more efficiently than most drugs;
• Plant juices – natural antibiotics (onion, garlic, cyclamen, aloe for the common cold).Their use is justified only for bacterial infections, but in this case there is a high probability of an increase in temperature. And this is a contraindication for steam inhalation. Therefore, in case of a cold, it is recommended to bury the juices of these plants;
• Solutions of medicinal herbs (chamomile, string, black currant) have mainly anti-inflammatory effects. It is allowed to use drugs of this group during a period when the disease has already begun to decline, and congestion is still present.

Inhalation with a runny nose is intended only to moisturize the nasal mucosa, therefore, the most effective drug for this procedure is saline. The rest of the drugs (antibacterial, vasoconstrictor, hormonal, homeopathic and traditional medicine) should be administered into the nose only by instillation.

Cough

The invention of ultrasonic and compressor nebulizers significantly expanded the possibilities for inhalation. It became real to carry out the procedure with almost any medication.However, when treating the respiratory tract, especially a child, be sure to consult a local pediatrician about the appropriateness of using this or that remedy.

What is the danger of a symptom – a blocked ear with a runny nose?

How to treat allergies during pregnancy, if it manifests itself as a runny nose, is described here.

Causes of dry cough in a child //drlor.online/diagnostika-lechenie/kashel/osnovnye-prichiny-suxogo-u-rebyonka.html

Depending on the stage of the disease, the type of cough, the area of ​​inflammation, the individual characteristics of the patient’s health, the doctor may prescribe the following drugs:

• Bronchodilators: Berodual, Atrovent, Salgim;
• Mucolytics: Fluimucil, Lazolvan, ACC;
• Anti-inflammatory: Rotokan, Tonsilgon H;
• Hormonal and antihistamines: Pulmicort, Dexamethasone, Cromohexal;
• Antibiotics and antiseptics: Fluimucil, Chlorophyllipt, Gentamicin, Miramistin;
• Immunomodulators: Interferon, Derinat;
• Antitussives: Lidocaine, Tussamag.

From folk remedies, the most common use of herbal infusions, which are made at the rate of 1 tbsp. l. dry raw materials per 200 ml of boiling water. Insist for 0.5 hour and filter thoroughly. Herbs are used for inhalation:

• Ledum;
• Elecampane high;
• Pine buds;
• Mother and Stepmother;
• Mint;
• Plantain.

It is possible to carry out inhalations at home several times a day, especially with medicinal herbs.In this case, it is necessary to observe the dosage of the drug and not exceed the time of the procedure. Remember to take precautions when using a steam inhaler.

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Conclusions

Treatment with an inhaler is one of the most effective methods of preventing and getting rid of unpleasant symptoms of respiratory infections. It is especially important to carry out procedures at the initial stages of the disease and during the recovery period.

Don’t know which inhaler is better, compressor or ultrasonic? When choosing a suitable device, consider all the characteristics of the inhaler and the purpose for which it is intended.