Bronchodilators for the COPD Patient

Different bronchodilators vary in terms of how fast they work and how long they last. The three types of bronchodilators are: beta2-agonists, anticholinergics, and theophylline. Your doctor will work with you to decide which bronchodilators are best for you.

Beta2-Agonists

Beta2-agonists work by relaxing the smooth muscle in the lungs, which enlarges the airways and makes it easier to breathe. Beta2-agonists are usually taken through an inhaler or nebulizer.

Beta2-agonists come in both short-acting and long-acting forms. The short-acting forms start to work within 3 to 5 minutes and last for 4 to 6 hours. They are sometimes called "reliever" or "rescue" bronchodilators. The long-acting forms take 20 minutes to work, but their effect lasts for up to 12 hours. Some common beta2-agonists are: albuterol, Foradil, and Serevent.

Possible side effects of beta2-agonists are fast heartbeat, shakiness and cramping of hands, legs and feet. These side effects should go away after a few days. If they do not, talk to your doctor.

Anticholinergics

Anticholinergic bronchodilators are slow-acting, so they should not be used for quick relief of symptoms. Because they are used on a daily basis, they are sometimes called "maintenance bronchodilators." Some anticholinergics last for 6 to 8 hours, others last for up to 24 hours. Anticholinergics are taken through an inhaler.

You may be given an anticholinergic along with a beta2-agonist, because the two medications work better together than either one does alone. A short-acting and a long-acting bronchodilator also may be given together for fast action and long-lasting relief.

Anticholinergics have fewer side effects than beta2-agonists. The most common side effect is dry mouth.

Theophylline

Theophylline is no longer used as a primary treatment for COPD. It may be added to a patient's existing regimen to help control an exacerbation. However, this medication should not be used by patients with heart failure or liver problems.

Doctors are not sure exactly how theophylline works, but it can relax the muscles in the airways, strengthen the diaphragm, and help the body clear mucus. It is available only in pills and comes in both short-lasting and long-lasting formulas.

The amount of theophylline you take must be carefully supervised, because too much of the drug can cause serious side effects, such as nausea and vomiting, heart irregularities, and seizures. Other milder side effects can include: a fast heartbeat (called tachycardia), shakiness, nausea, and cramping of hands, legs and feet.

Benefits of Bronchodilators

Bronchodilators help reduce many of the troublesome symptoms of COPD-such as coughing, wheezing, and breathlessness. Many people find they can exercise longer with bronchodilators, which helps improve their overall health status. Bronchodilators also may help increase the time between exacerbations, when COPD symptoms are worse, which reduces the need for hospital stays.