Understanding Your Bronchodilator

As part of the plan for managing your asthma, your doctor has prescribed a bronchodilator to relieve your asthma symptoms. One of two types of medications used to treat asthma, bronchodilators relax the muscles surrounding your airways, or bronchial tubes, so that they open more fully and allow you to breathe more freely. When these muscles contract and cause bronchospasm, your airways narrow considerably. While short-acting bronchodilators are successful in relieving symptoms by opening airways during an episode, they do not reduce or inhibit the inflammation and swelling within your airways.

Your doctor will prescribe the form of bronchodilator most likely to be effective for you. Bronchodilators are available in several forms — pills, liquids, inhalants, and injections — with inhaled medications being most commonly prescribed.

Commonly used bronchodilators are inhaled B2-receptor stimulants (agonists). As you breathe in, these medications go directly into your lungs and deposit on the restricted airways. There are two types of inhaled B2-agonists: short-acting and long-acting. The short-acting B2-agonist acts almost immediately to relieve symptoms. The long-acting B2-agonist is intended to help prevent asthma symptoms, should be taken twice daily to help prevent your airways from narrowing, and should never be used to treat sudden symptoms.

Short-Acting B2-Agonist Bronchodilator

For persons who encounter only occasional episodes of asthma — for instance, two or three times a week — a short-acting bronchodilator may be prescribed. This provides quick relief and is suited for people who are otherwise free of symptoms most of the time. The most common side effects are tremor, cough, and headache.

Inhaled short-acting bronchodilators begin acting quickly, reach their peak of relief within two hours, and can be taken every four hours as needed.

Long-Acting B2-Agonist Bronchodilator

For persons who suffer from chronic episodes of asthma, a long-acting bronchodilator can be prescribed as part of a stabilizing maintenance program. The medication is taken regularly to constantly maintain airway opening. Long-acting bronchodilators are commonly taken once in the morning and once in the evening, approximately 12 hours apart. The most common side effects are tremor, cough, and headache.

Corticosteroids

Corticosteroids are anti-inflammatory medications that reduce the swelling and hypersensitivity of the airways. They are very effective in the regular maintenance of asthma control and address an underlying problem — inflammation. While they cannot treat a sudden episode, they can reduce airway inflammation that contributes to symptoms. Corticosteroids are available as an inhalant, tablet, suppository, liquid, or injection. They are a synthetic steroid derived from a natural hormone already produced in your body, and are in no way related to the anabolic steroids sometimes misused by athletes to increase muscle mass.

If you have been prescribed a long-acting inhaled B2-agonist in addition to a corticosteroid, do not discontinue your corticosteroid without consulting your doctor — even if you feel better. The most common side effects when taken orally are increased appetite, fluid retention, and weight gain. When inhaled, the most common side effects are yeast infections in the mouth, sore throat, hoarseness, and coughing. You can minimize your risk of yeast infections by rinsing your mouth with water after every use. You may also be advised to use a spacing device with your inhaler.

Leukotriene Modifiers

These oral medications are designed to help reduce airway inflammation seen in asthma. They may be prescribed alongside inhalers or on their own, and are meant to be taken routinely as preventive medications — not on an as-needed basis. These medications are effective in cold air, exercise, allergy, and aspirin-induced asthma. Some drug interactions do exist.