<h1 id="page-title"><strong style="font-size: 14px;">Bronchodilators are a type of medication that&nbsp;make breathing easier by</strong><span style="font-size: 14px;">&nbsp;</span><strong style="font-size: 14px;">relaxing the muscles in the lungs and widening</strong><span style="font-size: 14px;">&nbsp;</span><strong style="font-size: 14px;">the airways (bronchi).</strong></h1>

<section id="block-system-main">
<p>They&#39;re often used to treat long-term conditions&nbsp;where the airways&nbsp;may become narrow and inflamed, such as:</p>

<ul>
	<li><a href="http://www.nhs.uk/conditions/Asthma/Pages/Introduction.aspx">asthma</a>&nbsp;&ndash;&nbsp;a common lung condition caused by inflammation of the airways</li>
	<li><a href="http://www.nhs.uk/conditions/Chronic-obstructive-pulmonary-disease/Pages/Introduction.aspx">chronic obstructive pulmonary disease (COPD)</a>&nbsp;&ndash;&nbsp;a lung disease usually caused by smoking which causes blockage of the airways, although this can be partially reversed with treatment&nbsp;</li>
</ul>

<p>Bronchodilators&nbsp;may be&nbsp;either:</p>

<ul>
	<li>short-acting&nbsp;&ndash;&nbsp;used as short-term relief from sudden, unexpected attacks of&nbsp;<a href="http://www.nhs.uk/conditions/shortness-of-breath/Pages/Introduction.aspx">breathlessness</a></li>
	<li>long-acting&nbsp;&ndash;&nbsp;used regularly, to help control breathlessness in asthma and COPD and&nbsp;increase the effectiveness of&nbsp;<a href="http://www.nhs.uk/Conditions/Corticosteroid-(drugs)/Pages/Introduction.aspx">corticosteroids</a>&nbsp;in asthma (see below)</li>
</ul>

<h2><a id="1" name="1">Bronchodilators and corticosteroids</a></h2>

<p>Inhaled&nbsp;<a href="http://www.nhs.uk/conditions/Corticosteroid-(drugs)/Pages/Introduction.aspx">corticosteroids</a>&nbsp;are the main treatment to reduce inflammation and prevent flare-ups in asthma.</p>

<p>But some people may also benefit from taking bronchodilators to keep the airways open and to enhance the effects of corticosteroids. Long-acting bronchodilators should never be taken without corticosteroids.</p>

<p>In COPD, initial treatment is with short- or long-acting bronchodilators, with corticosteroids added in some severe cases.</p>

<p>Treatment with corticosteroids and bronchodilators may require the use of separate inhalers, but increasingly these medications are provided together in single inhalers.</p>

<h2><a id="2" name="2">Types of bronchodilator</a></h2>

<p>The three most widely used bronchodilators are:</p>

<ul>
	<li><a href="http://www.nhs.uk/Conditions/Bronchodilator-drugs/Pages/Introduction.aspx#beta">beta-2 agonists</a>&nbsp;&ndash;&nbsp;such as&nbsp;salbutamol, salmeterol, formoterol and vilanterol</li>
	<li><a href="http://www.nhs.uk/Conditions/Bronchodilator-drugs/Pages/Introduction.aspx#anti">anticholinergics</a>&nbsp;&ndash;&nbsp;such as&nbsp;ipratropium, tiotropium, aclidinium and glycopyrronium</li>
	<li><a href="http://www.nhs.uk/Conditions/Bronchodilator-drugs/Pages/Introduction.aspx#theo">theophylline</a></li>
</ul>

<p>Beta-2 agonists and anticholinergics are available in both short-acting and long-acting forms, whereas theophylline is only available in a long-acting form.</p>

<h3><a id="3" name="3"><strong>Beta-2 agonists</strong></a></h3>

<p>Beta-2 agonists are used for both asthma and COPD, although some types are only available for COPD. They&#39;re usually inhaled using a small, hand-held inhaler but may&nbsp;also be&nbsp;available as tablets or syrup.</p>

<p>For sudden, severe symptoms they can also be injected or nebulised. A nebuliser is a compressor used to turn liquid medication into a fine mist, allowing a large dose of the medicine to be inhaled through a mouthpiece or face mask.</p>

<p>Beta-2 agonists work by stimulating receptors called beta-2 receptors in the muscles that line the airways, which causes them to relax and allows the airways to dilate (widen).</p>

<p>They should be used with caution in people with:</p>

<ul>
	<li>an&nbsp;<a href="http://www.nhs.uk/conditions/Thyroid-over-active/Pages/Introduction.aspx">overactive thyroid (hyperthyroidism)</a>&nbsp;&ndash;&nbsp;a condition that occurs when there&#39;s too much thyroid hormone in the body</li>
	<li><a href="http://www.nhs.uk/conditions/cardiovascular-disease/Pages/Introduction.aspx">cardiovascular disease</a>&nbsp;&ndash;&nbsp;any&nbsp;disease of the heart or blood vessels</li>
	<li>an&nbsp;<a href="http://www.nhs.uk/Livewell/Healthyhearts/Pages/Arrhythmias.aspx">irregular heartbeat (arrhythmia)</a></li>
	<li><a href="http://www.nhs.uk/conditions/Blood-pressure-(high)/Pages/Introduction.aspx">high blood pressure (hypertension)</a></li>
	<li><a href="http://www.nhs.uk/Conditions/Diabetes/Pages/Diabetes.aspx">diabetes</a>&nbsp;&ndash;&nbsp;a lifelong condition that causes a person&#39;s blood sugar level to become too high</li>
</ul>

<p>In rare cases, beta-2 agonists can make some of the symptoms and possible complications of these conditions worse.</p>

<h3><a id="4" name="4"><strong>Anticholinergics</strong></a></h3>

<p>Anticholinergics (also known as antimuscarinics)&nbsp;are&nbsp;mainly used for COPD but a few are also licenced for asthma. They&#39;re usually taken using an inhaler but may&nbsp;be nebulised to treat sudden and severe symptoms.</p>

<p>Anticholinergics cause the airways to dilate by blocking the cholinergic nerves. These nerves release chemicals that can cause the muscles lining the airways to tighten.</p>

<p>&nbsp;</p>

<p>They&nbsp;should be used with caution in people with:</p>

<ul>
	<li><a href="http://www.nhs.uk/conditions/prostate-enlargement/pages/introduction.aspx">benign prostatic hyperplasia</a>&nbsp;&ndash;&nbsp;a non-cancerous swelling of the prostate</li>
	<li>a bladder outflow obstruction&nbsp;&ndash;&nbsp;any condition that affects the flow of urine out of the bladder, such as&nbsp;bladder stones or&nbsp;<a href="http://www.nhs.uk/conditions/Cancer-of-the-prostate/Pages/Introduction.aspx">prostate cancer</a></li>
	<li><a href="http://www.nhs.uk/conditions/Glaucoma/Pages/Introduction.aspx">glaucoma</a>&nbsp;&ndash;&nbsp;a build-up of pressure in the eye</li>
</ul>

<p>In people with benign prostatic hyperplasia or a bladder outflow obstruction,&nbsp;anticholinergics can cause&nbsp;urination problems. Glaucoma can&nbsp;get worse if&nbsp;anticholinergic medication unintentionally gets into the eyes.</p>

<h3><a id="5" name="5"><strong>Theophylline</strong></a></h3>

<p>Theophylline is usually taken in tablet or capsule form, but&nbsp;a different version called aminophylline can be&nbsp;given directly&nbsp;into a vein (intravenously) if your symptoms are severe.</p>

<p>It&#39;s unclear exactly how theophylline works, but&nbsp;it seems to reduce any inflammation (swelling) in the airways, in addition to relaxing the muscles lining them.</p>

<p>The effect of theophylline is weaker&nbsp;than other bronchodilators and corticosteroids. It&#39;s also more likely to cause side effects, so is often only used alongside these medicines if they&#39;re not effective enough.</p>

<p>Theophylline should be used with caution in people with:</p>

<ul>
	<li>an overactive thyroid</li>
	<li>cardiovascular disease</li>
	<li>liver problems&nbsp;&ndash;&nbsp;such as&nbsp;<a href="http://www.nhs.uk/conditions/liver_disease_(alcoholic)/Pages/Introduction.aspx">liver disease</a></li>
	<li>high blood pressure</li>
	<li><a href="http://www.nhs.uk/conditions/Peptic-ulcer/Pages/Introduction.aspx">stomach ulcers</a>&nbsp;&ndash;&nbsp;open sores that develop on the stomach lining</li>
	<li><a href="http://www.nhs.uk/conditions/Epilepsy/Pages/Introduction.aspx">epilepsy</a>&nbsp;&ndash;&nbsp;a condition that affects the brain and causes repeated seizures (fits)</li>
</ul>

<p>Theophylline may cause these conditions to get worse. In people with liver problems, it can sometimes lead to a dangerous build-up of medication in the body. Other medicines can also cause abnormal build-up of theophylline in the body and this should always be checked by your doctor.</p>

<p>Elderly people may also need additional monitoring while taking theophylline.</p>

<h2><a id="6" name="6">Side effects</a></h2>

<p>The side effects of bronchodilators can vary, depending on the specific medication you&#39;re taking. Make sure you read the leaflet that comes with your medication to see what the specific side effects are.</p>

<p>General side effects of bronchodilators include:</p>

<ul>
	<li>trembling, particularly in the hands</li>
	<li><a href="http://www.nhs.uk/conditions/Headache/Pages/Introduction.aspx">headaches</a></li>
	<li>a&nbsp;<a href="http://www.nhs.uk/conditions/dry-mouth/Pages/Introduction.aspx">dry mouth</a></li>
	<li>suddenly noticeable heartbeats (<a href="http://www.nhs.uk/conditions/Heart-palpitations/Pages/Introduction.aspx">palpitations</a>)</li>
	<li>muscle cramps</li>
	<li>a&nbsp;<a href="http://www.nhs.uk/conditions/Cough/Pages/Introduction.aspx">cough</a></li>
	<li>nausea and vomiting</li>
	<li><a href="http://www.nhs.uk/Conditions/diarrhoea/Pages/Introduction.aspx">diarrhoea</a></li>
</ul>

<p>Read more about the&nbsp;<a href="http://www.nhs.uk/Conditions/Bronchodilator-drugs/Pages/Side-effects.aspx">side effects of bronchodilators</a>.</p>

<h2><a id="7" name="7">Pregnancy and breastfeeding</a></h2>

<p>In most cases, bronchodilators&nbsp;should be taken as normal while pregnant or breastfeeding.</p>

<p>However, speak to your GP if you regularly use bronchodilators and are considering having a baby or think you might be pregnant.</p>

<p>Pregnancy may affect your&nbsp;<a href="http://www.nhs.uk/conditions/Asthma/Pages/Introduction.aspx">asthma</a>, so it&#39;s important&nbsp;to continue taking your medication and have it monitored regularly, to ensure the condition is controlled.</p>

<p>Read more about&nbsp;<a href="http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/medicines-in-pregnancy.aspx">taking medication during pregnancy</a>.</p>

<h2><a id="8" name="8">Interactions with other medicines</a></h2>

<p>Bronchodilators may interact with other medicines, which could affect the way they work or increase your risk of side effects.</p>

<p>Some of the medicines that can interact with bronchodilators (particularly theophylline) include:</p>

<ul>
	<li>some&nbsp;diuretics&nbsp;&ndash;&nbsp;a type of medication that helps remove fluid from the body</li>
	<li>some&nbsp;<a href="http://www.nhs.uk/conditions/Antidepressant-drugs/Pages/Introduction.aspx">antidepressants</a>&nbsp;&ndash;&nbsp;including monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs)</li>
	<li>digoxin&nbsp;&ndash;&nbsp;a medication used to treat&nbsp;arrhythmias</li>
	<li>benzodiazepines&nbsp;&ndash;&nbsp;a&nbsp;type of sedative that may sometimes be used as a short-term treatment for&nbsp;<a href="http://www.nhs.uk/conditions/anxiety/pages/introduction.aspx">anxiety</a>&nbsp;or&nbsp;<a href="http://www.nhs.uk/conditions/Insomnia/Pages/Introduction.aspx">sleeping problems (insomnia)</a></li>
	<li>lithium&nbsp;&ndash;&nbsp;a medication used to treat severe&nbsp;<a href="http://www.nhs.uk/conditions/depression/Pages/Introduction.aspx">depression</a>&nbsp;and&nbsp;<a href="http://www.nhs.uk/conditions/Bipolar-disorder/Pages/Introduction.aspx">bipolar disorder</a></li>
	<li>quinolones&nbsp;&ndash;&nbsp;a type of&nbsp;<a href="http://www.nhs.uk/conditions/Antibiotics-penicillins/Pages/Introduction.aspx">antibiotic medication</a></li>
</ul>

<p>This isn&#39;t a complete&nbsp;list of all the medications that can interact with bronchodilators, and not all of these interactions apply to each type of bronchodilator.</p>

<p>&nbsp;</p>

<p><strong>Source:</strong>&nbsp;<a href="http://www.nhs.uk/Conditions/Bronchodilator-drugs/Pages/Introduction.aspx">http://www.nhs.uk/Conditions/Bronchodilator-drugs/Pages/Introduction.aspx</a></p>
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