Bronchodilators and Asthma

A bronchodilator is used by almost all people with asthma as a way to open the airway passages.

Short-acting bronchodilators are used as a "quick relief" or "rescue" medication, while long-acting bronchodilators can be used every day to control asthma -- in conjunction with an inhaled steroid.

What Are the Types of Bronchodilators for Asthma?

For treating asthma symptoms, there are three types of bronchodilators: beta-agonists, anticholinergics, and theophylline. These bronchodilators are available in inhaled, tablet, liquid, and injectable forms, but the preferred method of taking the beta-agonists and anticholinergics is by inhalation.

What Are Short-Acting Bronchodilators?

Short-acting bronchodilators are called "quick-acting," "reliever," or "rescue" medications. These bronchodilators relieve acute asthma symptoms or attacks very quickly by opening the airways. The rescue medications are best for treating sudden asthma symptoms. The action of inhaled bronchodilators starts within minutes after inhalation and lasts for two to four hours. Short-acting bronchodilators are also used before exercise to prevent exercise-induced asthma.

For more information, see WebMD's article onAsthma Inhalers.

Short-acting bronchodilators can be used in an asthma nebulizer in the form of a liquid to treat an asthma attack at home.

For in-depth information, see WebMD's article on Asthma Nebulizers (Breathing Machines).

Overuse of short-acting bronchodilators, whether in asthma inhalers, in tablets, or in liquid, is a sign of uncontrolled asthma that needs better treatment. If you need to use your short-acting bronchodilators more than twice a week, talk with your doctor about improving your asthma control therapy.

Short-Acting Bronchodilator Inhalers Available in the United States Include:

What Are Long-Acting Bronchodilators for Asthma?

The long-acting bronchodilators are used to provide control -- not quick relief -- of asthma. They should only be used in conjunction with inhaled steroids for long-term control of asthma symptoms. The long-acting bronchodilators are used twice a day.

Long-Acting Bronchodilator Asthma Inhalers Available in the United States Include:

  • Advair, Dulera, and Symbicort (a combination of a long-acting beta-agonist bronchodilator and an inhaled steroid)
  • Serevent (salmeterol)
  • Foradil (formoterol)
  • Perforomist (formoterol solution for nebulizers)

Long-acting beta-agonist bronchodilators increase the risk of death from asthma and should only be used as additional treatment for people who are also using an inhaled steroid. For details, talk to your doctor and see their black-box warning.

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Are There Common Side Effects of Bronchodilators Used for Asthma?

Bronchodilators can have side effects such as:

How Do the Anticholinergic Bronchodilators Work?

The anticholinergics are bronchodilators mainly used for treating COPD (chronic obstructive pulmonary disease such as emphysema) and not commonly used for asthma.

Atrovent (an anticholinergic bronchodilator) is available as an inhaler and also in a nebulizer solution. A dry throat is the most common side effect. If the medication gets in the eyes, it may cause blurred vision for a short period of time. A long-acting anticholinergic inhaler, Spiriva (tiotropium), is also available for patients with COPD (as proven by airway obstruction that persists after an inhaled bronchodilator).

What Is the Bronchdilator Theophylline?

Theophylline is a relatively weak but inexpensive bronchodilator that has a chemical similar to caffeine. Theophylline relaxes the smooth muscle that surrounds the airways.

Theophylline is sold as a generic pill or under the brand names Uniphyl and Theo-24. Theophylline is available as an oral (pill and liquid) or intravenous (through the vein) drug. Theophylline is available in short and long-acting forms and prevents asthma symptoms, especially nighttime symptoms. It is used less often for asthma, because it requires blood-level monitoring.

What Are the Side Effects of Theophylline?

Side effects of theophylline include:

These side effects may also be a sign of having taken too much medication. Your doctor will check your blood levels of the drug to make sure you are receiving the proper amount.

Always tell your doctors if you take theophylline for asthma, because certain medications, such as some antibiotics, seizure medicines, and ulcer medicines, can interact with theophylline. Also, make sure your doctor knows about any other medical conditions you may have, because some diseases and illnesses can change how your body responds to theophylline.

And keep in mind that not only is smoking and exposure to cigarette smoke especially dangerous for those with asthma, but it can also interfere with how your body responds to theophylline. Therefore, it is best to avoid smoke and cigarette smoking.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on January 20, 2015

Sources

SOURCES:

American Academy of Asthma, Allergy & Immunology: "Asthma" and "Allergy and Asthma Drug Guide."


National Jewish Medical and Research Center: "Inhaled Medication with a Metered Dose Inhaler (MDI)." 

Asthma Society of Canada: "How to Use Your Inhaler."

Science Daily: "New Asthma Inhaler Propellant Effective, but Costlier."

Children's Hospital Boston: "Allergy Treatment."

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