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Bronchodilators

Bronchodilators, expectorants, and antitussive drugs are used to treat respiratory conditions. Bronchodilators widen airways by relaxing muscles in the lungs. There are different types including beta-2 agonists, anticholinergics, and xanthine derivatives. Expectorants thin mucus in the lungs making it easier to cough up. Common expectorants include guaifenesin. Antitussives suppress coughing by inhibiting the cough reflex center in the brain.

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93 views25 pages

Bronchodilators

Bronchodilators, expectorants, and antitussive drugs are used to treat respiratory conditions. Bronchodilators widen airways by relaxing muscles in the lungs. There are different types including beta-2 agonists, anticholinergics, and xanthine derivatives. Expectorants thin mucus in the lungs making it easier to cough up. Common expectorants include guaifenesin. Antitussives suppress coughing by inhibiting the cough reflex center in the brain.

Uploaded by

ted deang
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© © All Rights Reserved
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BRONCHODILATORS,

EXPECTORANTS, AND
ANTITUSSIVE DRUGS
TEDHALEY A. DEANG, RN, MAN
BRONCHODILATORS

• Bronchodilators are a type of medication that make


breathing easier by relaxing the muscles in the lungs and
widening the airways (bronchi).
BRONCHODILATORS

• Respiratory diseases, such as asthma and


chronic obstructive pulmonary disease (COPD), cause bronchospasm,
which is constriction or narrowing of the airways.
• Narrowed airways make it challenging for a person to cough mucus up. It
also makes it difficult for them to get air in and out of the lungs. Taking a
bronchodilator helps dilate or widen the airways, making it easier to
breathe.
HOW BRONCHODILATORS WORK

• Bronchodilators work by relaxing the muscles in the airways. The


relaxation causes the airways to open up and the bronchial tubes to widen.
There are different types, each working in slightly different ways. They
include:
• beta 2-agonists
• anticholinergics
• xanthine derivatives
BETA-2 AGONIST

• This class of bronchodilator causes the smooth muscles surrounding the airways to relax
by stimulating beta-adrenoceptors in the airways. This improves airflow and reduces
symptoms, such as shortness of breath.
• Beta-2 agonists come in short-acting varieties to dilate the airway immediately, and
long-acting varieties, which maintain open airways. Short-acting beta-2 agonists include:
• salbutamol (albuterol)
• levalbuterol
• pirbuterol
ANTICHOLINERGIC DRUGS

• Anticholinergic bronchodilators block the action of acetylcholine. Acetylcholine is a chemical


released by the nerves that can lead to tightening of the bronchial tubes. By blocking the
chemical, anticholinergic bronchodilators cause the airways to relax and open.
• As with beta-2 agonists, Anticholinergic drugs come in both short-acting and long-acting forms.
Some long-acting forms include:
• aclidinium bromide
• tiotropium bromide
• glycopyrrolate or glycopyrronium bromide
• umeclidinium bromide
Ipratropium is an exam of short-acting anticholinergic
XANTHINE DERIVATIVES
• Xanthine derivatives also relax the airway muscles, although doctors do not know
precisely how they work.
• The main xanthine derivative is theophylline. Theophylline comes in an oral and
intravenous injectable form. Doctors now rarely prescribe theophylline due to many
people experiencing significant side effects. At relatively low doses, it can cause:
• nausea
• vomiting
• irregular heart rhythms
• irritability
• dizziness
• seizures
TYPES OF BRONCHODILATORS

• There are two main types of bronchodilators: long-acting and short-acting.


Both types have a role in treating common lung diseases, such as asthma
and COPD.
• Both beta 2-agonists and anticholinergic bronchodilators come in a short-
acting and long-acting form.
SHORT-ACTING BRONCHODILATORS
• Doctors often call short-acting bronchodilators “rescue inhalers” or “fast-acting inhalers”
as they treat symptoms that come on suddenly, such as wheezing, shortness of breath,
and chest tightness.
• Short-acting bronchodilators work quickly, usually within a few minutes. Although they
work fast, the therapeutic effects generally only last 4–5 hours. Short-acting
bronchodilators treat sudden symptoms, and people do not need to use them when they
are symptom-free.
• Common short-acting bronchodilators include:
• albuterol (ProAir HFA, Ventolin HFA, Proventil HFA)
• levalbuterol (Xopenex HFA)
• pirbuterol (Maxair)
LONG-ACTING BRONCHODILATORS
• Long-acting bronchodilators do not work as quickly as short-acting
bronchodilators and do not treat acute or sudden symptoms. The effects can last
for up to 24 hours, and people take them daily to prevent symptoms from
developing.
• Common long-acting bronchodilators include:
• salmeterol (Serevent)
• formoterol (Perforomist)
• aclidinium (Tudorza)
• tiotropium (Spiriva)
• umeclidinium (Incruse)
SIDE EFFECTS
• As with most types of medications, bronchodilators may cause side effects.
• The severity of the side effects is sometimes dose-dependent. The higher the dose, the more likely it is that
side effects may develop. However, side effects can also occur with small doses.
• Side effects may also differ depending on whether the bronchodilator is a beta 2-agonist or an
anticholinergic. Possible side effects of bronchodilators include:
• increased heart rate
• tremors
• nervousness
• cough
• dry mouth
• nausea
• headache
• low potassium
EXPECTORANT

• An expectorant is a type of cough medicine that thins and loosens mucus.


These medications are typically used for managing chest congestion,
especially when symptoms are caused by a lot of mucus. Expectorants are
a mucoactive class of drugs—those that clear mucus from the airways.
• Guaifenesin is the most commonly used expectorant. It is the active
ingredient in Mucinex 404 and Robitussin. Expectorants come in different
forms, including over-the-counter (OTC) liquids, pills, and tablets.
USES OF EXPECTORANT

• Expectorants are commonly used for symptoms of short-term (acute)


respiratory tract infections, like the common cold, pneumonia, or
bronchitis.
• These infections can cause a buildup of phlegm in your throat or lungs. It
is often hard to cough up this thick mucus, and you can develop a nagging
cough and chest discomfort when the mucus builds up.
• Expectorants thin respiratory secretions in your airways so that you can
cough up extra mucus more effectively. These medications help by
lubricating the airway passages.
REMEMBER

• Expectorants can make you more comfortable, but they do not


treat the underlying cause of chest congestion. You may need to
use another treatment with an expectorant—such as antibiotics
or steroids—to clear up the illness that is making you
congested.
TYPES OF EXPECTORANT

• There are many brand-name over-the-counter (OTC) products and prescriptions with
guaifenesin in them. It is also available in generic form. Combination expectorants can
relieve cold symptoms in a few ways.
• Robitussin DM and Mucinex DM are a combination of guaifenesin and
dextromethorphan. Mucaphed is a combination of guaifenesin and phenylephrine (the
active ingredient in Sudafed).
NATURAL EXPECTORANTS

• While there are some home remedies that can act like an expectorant,
they’re not the same as an OTC or prescription product.
• These remedies can help with symptoms but do not treat the underlying
cause of symptoms.
NATURAL EXPECTORANTS
• Examples of natural expectorants include:
• Honey: Honey is a popular sore throat remedy and may also help with a cough. It can be taken
by spoonful or added to tea. Just remember that babies under 1 year old cannot have honey.
• Ginger: Ginger may help with a stuffy nose and chesty cough. You can get lozenges made
with ginger or use some fresh ginger to add to tea. (It might even be more helpful if you add
honey, too.)
• Garlic: Garlic might help with common cold symptoms, including a cough. While you can
add fresh garlic to hot water to make a soothing drink, the taste might be a little too strong.
Instead, try adding it to hot water to create steam you can inhale to help clear up a cough.
NATURAL EXPECTORANTS
• Eucalyptus: Many natural cough remedies have eucalyptus in them. You can use the oil
to make steam to breathe in to help ease congestion and cough, but you should not
consume it by mouth.
• Menthol: Minty cool menthol is another popular natural ingredient in cough and cold
products. You can use it to help with a cough as well as make a sore throat feel better.
• Water: Believe it or not, simply staying hydrated by drinking plenty of water will go a
long way to helping clear up mucus, soothe throat irritation, and calm a cough.
REMEMBER

• While many natural cold remedies are considered safe in general, they
may not be safe for you to use depending on your health and the
medications you take. Always ask your provider or pharmacist before you
try a natural remedy or supplement. And consult a healthcare provider if
your cough does not get better after you've been treating it at home.
BEFORE TAKING

• You usually will not need to have any medical tests before using an
expectorant. Your provider may recommend that you use one early in the
course of your illness—as soon as it becomes clear that mucus is causing
your symptoms.
• However, you should not take an expectorant if you had a serious
(adverse) reaction to using one in the past.
SIDE EFFECTS

• Expectorants do not commonly cause serious side effects. The most


common side effects of expectorants include dizziness, drowsiness, and
rash.
ANTITUSSIVE
• Antitussives are medicines that suppress coughing, also known as
cough suppressants. Antitussives are thought to work by inhibiting a
coordinating region for coughing located in the brain stem, disrupting
the cough reflex arc; although the exact mechanism of action is
unknown.
• However, their use is not without controversy and they should only be
considered for dry, irritating coughs that do not involve mucus
production. Suppressing productive or mucus-producing coughs
caused by some respiratory diseases with antitussives may be
hazardous. Many viral coughs are best treated by increasing fluid
intake and exposing the airways to humidity.
HOW TO TAKE ANTITUSSIVES

• Taking antitussives will vary based on the formula and type. Oral antitussives involve swallowing the
medication, often as a syrup, while topical antitussives involve rubbing the medicated cream or
ointment onto the skin.
• A person should follow all instructions from a doctor or pharmacist when taking oral medications.
They should also read and follow instructions on any OTC medication.
• Doses and dosages for oral medications can vary, so a person should make sure they know how much
to take and how frequently they should take it.
• People with sensitive skin may want to speak with a doctor or pharmacist before applying topical
antitussives.
• If the cough persists for more than 2 weeks or if it worsens even with treatment, a person should
contact a doctor for advice.
POSSIBLE SIDE EFFECTS OF ANTITUSSIVES
• Codeine can cause several side
effects, including: • hypersensitivity
• constipation • blurred vision
• pruritus or itchy skin • sexual dysfunction and reduced
• sedation libido
• fatigue • tremors
• weakness • pancreatitis
• bronchospasm
POSSIBLE SIDE EFFECTS OF ANTITUSSIVES

• Some possible side effects of dextromethorphan include:


• lightheadedness
• dizziness
• drowsiness
• nausea
• vomiting
• stomach pain
• restlessness
• nervousness

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