What you need to know about bronchodilators for breathing difficulties

Do you sometimes suddenly find it difficult to breathe? Does your chest feel tight and suffocating? This is a very common and very uncomfortable experience, especially for someone with a long-term respiratory disease like asthma or COPD (Chronic Obstructive Pulmonary Disease). So, in this article, we are going to talk very simply about the inhaler that comes to our aid at times like these and makes breathing easier. The medical name for these is 'Bronchodilators'.

Simply put, what is this Bronchodilator?

This name may sound a bit complicated, but its functionality is very simple. Let's understand it this way.

Imagine that you have a network of tiny tubes that carry air to your lungs. These are called bronchi. Normally, air moves easily through these tubes. But in conditions like asthma, the delicate muscles around these tubes tighten, narrowing the openings in the tubes. It's like someone squeezing a water pipe. What happens then? There's not enough room for air to pass through. The result is difficulty breathing, wheezing, and chest tightness.

Bronchodilators relax the tight muscles and dilate the narrowed airways. This allows air to pass through better and makes breathing easier. That's exactly what the name means. 'Broncho' means airway, and 'dilator' means something that widens.

There is another benefit to these medications. When the airways widen, it becomes easier for things like mucus that are stuck in them to come out. Then it is easier to cough up the mucus.

These medications are mainly available to us as inhalers and nebulizer solutions. A nebulizer is a machine that turns the medication into a fine mist, making it easier to breathe in.

There are two main types of bronchodilators:

These medications can be divided into two main categories based on their speed and duration of action. Understanding the difference between the two is very important for your treatment.

What are the main types of bronchodilators?

These medications are further divided into 3 main types based on how they work.

1. Beta 2-agonists

These are the most commonly used types. They are available in both short-acting and long-acting forms.

• Short-acting beta 2-agonists (SABAs): These are the "Rescue Inhalers" we mentioned earlier. These help provide quick relief when asthma symptoms come on. They work within 15-20 minutes and provide relief for about 4-6 hours. If used before exercise, they can also prevent exercise-induced asthma.
• Examples: Albuterol (Ventolin®), Levalbuterol (Xopenex®)

• Long-acting beta-2 agonists (LABAs): These are used to control the disease long-term, usually twice a day. It is important to remember that LABAs are never used alone when treating asthma. They are always given in combination with a corticosteroid inhaler. Steroids work by reducing inflammation in the airways.
• Examples: Salmeterol (Serevent®), Formoterol (Foradil®)
• Combination medications with steroids: Fluticasone and Salmeterol (Advair®), Budesonide and Formoterol (Symbicort®)

2. Anticholinergics

These medications work by blocking certain signals from our nervous system that cause the airways to constrict. They also help to widen the airways. These are not quick-relief medications. But they can help control asthma, especially in people with severe symptoms.

• Examples: Ipratropium bromide (Atrovent®), Tiotropium bromide (Spiriva Respimat®)

3. Theophylline

This is a medicine that comes in the form of a pill. It was used a lot in the past to control severe asthma. But it is not used as often now. This is because when using this medicine, you need to have regular blood tests to check that the level of the medicine in your body is correct. It also has a few more side effects.

Are there any side effects to this medicine?

Like any medicine, these bronchodilators can cause some side effects. But most of the time, these are not serious. Side effects vary depending on the type of medicine.

If you have a bladder condition, such as benign prostatic hyperplasia (BPE), it is important to inform your doctor when taking anticholinergic medications.

Is a bronchodilator a type of steroid?

No. This is where a lot of people get confused. A bronchodilator is not a steroid. The two have completely different functions.

• Bronchodilator: Widens constricted airways, making breathing easier instantly.
• Inhaled Steroid (Steroid Inhaler): Reduces swelling and inflammation in the airways. This helps control the disease in the long term .

Doctors often recommend using both types together to control diseases like asthma.

How to use the inhaler correctly?

To get the most out of your medication, it's important to know how to use your inhaler correctly. Many people do this incorrectly, which means the medicine doesn't get into their lungs properly. Here's the correct way to do it:

1. Shake well: Close the cap of the inhaler tightly and shake it well about 10-15 times.

2. Remove the cap: Remove the cap and set it aside.

3. Exhale: Take a deep breath in and exhale as much as possible. Empty your lungs.

4. Insert into mouth: Place the mouthpiece of the inhaler inside your mouth and close it tightly with your lips.

5. Inhale and breathe in: While pressing the top of the inhaler once, take a deep breath in through your mouth. (If you hear a honking sound, you are breathing in too fast. Take a deep breath in.)

6. Hold your breath: After inhaling, hold your breath for about 10 seconds. Count to 10 in your mind. This will give the medicine time to reach the very roots of the lungs.

7. Exhale: Exhale, please.

8. Wait a minute: If your doctor has told you to take more than one puff of the medication, wait about a minute before taking the next puff. Then start over from step 3.

9. Close the cap: When you are finished using it, be sure to close the cap again.

10. Rinse your mouth: If you are using a corticosteroid inhaler, this is a must. After using the medication, rinse your mouth thoroughly with water or mouthwash and throw it away. This can help prevent fungal infections in the mouth.

Is it good to use an inhaler more than necessary?

It is said that too much of anything is not good. This inhaler is no exception. If you use too much, especially a short-term "Rescue Inhaler", your body may not respond properly to the medicine after a while. It is also possible that your respiratory system may become more sensitive to things like smoke and dust. Therefore , always use the medicine only in the amount and as prescribed by your doctor .

When should you see a doctor?

If you have not been previously diagnosed with a respiratory illness, but are experiencing symptoms such as difficulty breathing, persistent cough, and wheezing, it is very important to see a doctor immediately and get proper testing.

If you are already using a bronchodilator, be sure to see your doctor in the following situations:

• If you need to use your rescue inhaler (SABA/Rescue Inhaler) more than twice a week, this is a major sign that your disease is not being properly controlled.
• If you feel that the current dose of medication is not enough to control your symptoms.
• If the side effects of the medication are causing you discomfort.

By talking to your doctor and developing a treatment plan that best suits you, you will be able to live a comfortable life.