Bronchodilators: functions, types and side effects

Asthma and COPD (chronic obstructive pulmonary disease) attack lung health. Both cause narrowing of the airways in the lungs, resulting in shortness of breath. One of the treatments used for shortness of breath is a bronchodilator. Hear more about this drug in the following review.

What are bronchodilators?

Bronchodilators are a type of medicine that make breathing easier by dilating the airways and relaxing the muscles in the lungs. This drug belongs to the non-steroidal drug class.

If you have asthma or COPD, your doctor will usually prescribe bronchodilators to make breathing easier. According to the University of Virginia website, the way bronchodilators work is to relax the muscles around the airways leading to the lungs thereby widening the airways and bronchial tubes.

This drug is actually not the main treatment for asthma patients who experience shortness of breath. Asthma people prefer to use inhaled corticosteroids to reduce inflammation and prevent symptoms from recurring.

However, some patients can use this type of drug to keep the airways free from constriction and increase the efficacy of the corticosteroid used.

Meanwhile, for the treatment of COPD, this drug can be used alone. The addition of corticosteroid drugs is usually only given to patients whose symptoms are more severe.

Types of bronchodilators based on their effect of action

Based on how it works, this drug is divided into two types, namely the fast effect and the long effect. To be clearer, let's discuss one by one.

1. Bronchodilator fast effect

Fast-acting bronchodilators are bronchodilators that work faster, but last only 4-5 hours. Usually this type is used to treat symptoms of shortness of breath that appear suddenly, such as wheezing, shortness of breath, and pain in the chest.

When symptoms do not appear, the patient may not need this drug. Some examples of fast-acting bronchodilator drugs include:

• albuterol (ProAir HFA, Ventolin HFA, Proventil HFA)
• levalbuterol (Xopenex HFA)
• pirbuterol (Maxair)

2. Long-term bronchodilator effect

This type is the opposite of the previous one. This medication works longer and lasts 12 hours to a full day.

This type is usually intended for daily use, not to relieve sudden symptoms. Some of the slow-acting bronchodilators include:

• salmeterol (Serevent)
• formoterol (Perforomist)
• aclidinium (Tudorza)
• tiotropium (Spiriva)
• umeclidinium (Incruse)

Types of bronchodilators based on the components

In addition to the effects of drug action, bronchodilators are also categorized based on their medicinal components, namely:

1. Beta-2 agonists

Beta-2 agonist bronchodilators consist of:

• salbutamol
• salmeterol
• formoterol
• vilanterol

This drug can be used for fast and long lasting effects. Usually, it is used by inhalation with a small handheld inhaler or nebulizer. It can also be in the form of small tablets or syrup.

However, people with certain conditions need to be careful using this drug, that is, people with conditions:

• hypothyroidism
• heart disease
• high blood pressure (hypertension)
• diabetes

The types of beta agonists that are approved for use include:

• Beta agonists short acting : albuterol, xopenex, metaproterenol, and terbutaline
• Beta agonists long acting : salmeterol, performomist, bambuterol, and indacaterol

2. Anticholinergics

These bronchodilators can consist of:

• ipratropium
• tiotropium
• aclidinium
• glycopyrronium

This drug belongs to the category of immediate and long-lasting effects and is primarily used for people with COPD. Even so, asthma patients can also use this drug.

Anticholinergics are most commonly used with inhalers. However, it is recommended that you use a nebulizer if the symptoms are severe enough for the drug to work more optimally.

The way this drug works is to dilate the airways by blocking cholinergic nerves, which are nerves that release chemicals to tighten the muscles around the lung passages.

People with an enlarged prostate, disorders of the bladder, and glaucoma need to be careful using this drug.

3. Methylxanthine

This type of bronchodilator works to relieve obstruction of airflow, reduce inflammation, and relieve bronchial contractions.

This drug is used as a last resort when both beta-agonists and anticholinergics do not have maximum effect. Unfortunately, this drug has bigger side effects than other drugs.

This drug cannot be inhaled, but is taken in pill form orally, in suppositories, or injected into a vein. Methylxanthine drugs that are approved for use include theophylline and aminophylline.

Side effects are more common when methylxanthines are given by injection. Side effects that usually occur are headaches, insomnia, nausea, diarrhea, and heartburn.

Bronchodilator side effects

The side effects of using this drug can vary, depending on which type you are using.

1. Side effects of the beta-2 agonist bronchodilator

Some of the side effects that occur after using beta-2 agonist bronchodilators such as salbutamol include:

• trembling, especially in the hands
• nerves tighten
• headache
• irregular heartbeat
• muscle cramp

The above effects generally go away on their own after a few days or weeks. Although very rare, it is possible that more serious side effects can occur, such as acute narrowing of the airways (paradoxical bronchospasm).

Excessive doses of beta-2 agonists also have the potential to cause heart attacks and low levels of potassium in the blood (hypokalemia).

2. Anticholinergic bronchodilator side effects

The main side effects of using anticholinergics are as follows:

• dry mouth
• constipation
• cough
• headache

Some of the less common effects include:

• nausea
• heartburn
• difficulty swallowing (dysphagia)
• irregular heartbeat
• throat irritation
• difficulty urinating

3. Methylxanthine bronchodilator side effects

Using methylxanthine drugs such as theophylline may cause the following side effects:

• nausea and vomiting
• diarrhea
• irregular, or faster heartbeat
• headache
• difficulty sleeping (insomnia)

The above side effects are more likely to occur in older people. This is because the liver function of the elderly has decreased, so that the body's ability to dispose of drugs deteriorates. Drugs that have accumulated too much in the body increase the risk of side effects.

Before using bronchodilators, make sure you consult your doctor first. Especially if you have certain medical problems, are pregnant, or are breastfeeding. Your doctor will help you choose the right medication to treat the symptoms of asthma or COPD that you have.

What needs to be considered before using this drug?

After choosing the right type of bronchodilator, the next step is to check the expiration date listed on the tube or drug package.

You also have to store it properly. Do not put this medication in a place exposed to sunlight or use it near a fire.

Avoid using other people's bronchodilator tubes or sharing your own tubes with other people. If you feel annoying side effects after using the drug, do not hesitate to consult a doctor. The doctor will change or add other drugs to reduce certain side effects.