Bronchodilators are medicines that help open the bronchial tubes (airways) ofthe lungs, allowing more air to flow through them. They are used by people with the condition asthma. People with asthma have trouble breathing, becausetheir airways are inflamed and narrowed.

Normally, air moves smoothly through the airways and into the tiny air sacs of the lungs while a person is breathing in (inhaling). Breathing out (exhaling) happens automatically when the person stops inhaling. In a person with asthma, inhaling is not a problem. Incoming air can slide around the blockage, because the act of inhaling makes the airways expand. The problem comes when the person with asthma tries to exhale. The air can no longer get past the blockage, and it remains trapped in the lungs. The person can then only take shallow breaths. Bronchodilators work by relaxing the smooth muscles that line the airways. This makes the airways open wider and allows air to leave the lungs. These drugs also are used to relieve breathing problems associated with emphysema, chronic bronchitis, and other lung diseases.

Some bronchodilators are inhaled, using a nebulizer or an inhalation aerosol.Others are taken as injections or by mouth. Examples of prescription bronchodilators are albuterol (Proventil, Ventolin), epinephrine (Primatene), ipratropium (Atrovent), metaproterenol (Alupent, Metaprel), and terbutaline (Brethine). A few bronchodilators, such as ephedrine, can be bought without a physician's prescription. However, even over-the-counter bronchodilators should only be used as recommended by a physician.

Check with the doctor who prescribed the bronchodilator or the pharmacist whofilled the prescription for the correct dosage of the drug. Always use thesemedicines exactly as directed. Taking larger than recommended doses or usingthe medicine too often can lead to serious side effects and even death.

People with certain medical conditions or who are taking certain other medicines can have problems if they use bronchodilators. In addition, anyone who has had unusual reactions to any bronchodilator or an inhaled form of any otherdrug in the past should let his or her physician know before taking the drugs again. If symptoms do not improve or if they get worse after using a bronchodilator, call a physician right away.

Some bronchodilators pass into breast milk. Breastfeeding mothers should check with their physicians before using bronchodilators.

Before using bronchodilators, people with any of these medical conditions should make sure their physicians are aware of their conditions:

  • Allergies--to sulfites, foods, medications, or other substances.
  • Pregnancy
  • Glaucoma
  • Brain damage
  • Convulsions (seizures)--recently or anytime in the past
  • Mental illness
  • Parkinson's disease
  • Diabetes
  • Heart or bloodvessel diseases
  • Rapid or irregular heartbeat
  • High blood pressure
  • Overactive thyroid
  • Enlarged prostate
  • Obstruction of the neck of the bladder.

The most common bronchodilator side effects are nervousness or restlessness and trembling. These problems usually go away as the body adjusts to the drugand do not require medical treatment. Less common side effects, such as dry mouth or throat, bad taste in the mouth, coughing, dizziness or lightheadedness, drowsiness, headache, sweating, fast or pounding heartbeat, muscle crampsor twitches, nausea, vomiting, diarrhea, sleep problems and weakness also mayoccur and do not need medical attention unless they do not go away or they interfere with normal activities.

More serious side effects are not common, but may occur. If any of the following side effects occur, check with the physician who prescribed the medicineas soon as possible:

  • Chest pain or discomfort
  • Irregular heartbeat
  • Unusual bruising
  • Hives or rash
  • Swelling
  • Wheezing or other breathing problems
  • Numbness in the hands or feet
  • Blurred vision

Bronchodilators may interact with a number of other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Be sure to check with a physician or pharmacist beforecombining bronchodilators with any other prescription or nonprescription (over-the-counter) medicine.

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