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  • Christina Hunt

What Your Breathing Medications Do For You


On my blog, I have reviewed how you can get the most from your breathing medications. I try to regularly review this information on my site, and I would suggest that if you are a “newbie” to BreatheLiveFit and you use breathing medications that you take some time to read over that blog. Sometimes patients can get a little “rusty” with their technique and so I think it is important to review proper technique and scheduling of these medications from time to time. The reason for today’s blog is to make sure you understand WHY you are taking these medications and what exactly they are supposed to do to help you in managing your lung condition. (Makes sense, right?!)


We all want to do our best to follow our physician’s orders. We trust that they know what is best in helping to manage our chronic lung condition, but I also believe that you should know WHY you are taking the medications that you are prescribed. Often time, patients can’t tell if some of their breathing medications are helping them or not. I believe it’s because they don’t know what they do and therefore have to go on the assumption that they are doing something to help them breathe more comfortably. Well, after today if you are prescribed breathing medications you will know what kind of medications they are and what they are presumably doing to help your lung condition.


Here’s some helpful advice when it comes to being informed about your breathing medications:

1. Know the names of your breathing medications and what they do to help your lungs (this is what we are covering today)

2. Know when to take your medications so that you get the most benefit from them

3. Make sure you are taking your medications exactly as they are prescribed and if you have questions… ask your doctor or pharmacist to clarify (even if you are in a rush to get home)

4. Know what types of side effects that you might expect to experience with the breathing medications that you are prescribed

5. Never let your breathing medications run out. Call or schedule your refills in a timely manner.

6. Do not take expired medications. You want to be sure that you are getting the most from your inhaled meds. One of the best ways to be sure that they will “pack a punch” is if they aren’t old and expired causing their ingredients to be less effective.


There are typically two classes of breathing medications:

1. Fast-acting (often referred to as quick-relief)

2. Controllers (often referred to as maintenance medications)


When you have a chronic lung condition you will often be prescribed medications from each of these two categories. Make sure you know which of your breathing medications belong to each category. This is the first step to understanding what they do and how they can help you.


Fast-Acting (Short-Acting) Bronchodilators

These are the inhaled medications that respond to your shortness of breath in a fast way. Often referred to as your “rescue inhaler,” these medications are effective within about 5 minutes of their use. They work to open the airways by relaxing the smooth muscles in the airways. If you experience a sudden onset of shortness of breath, this is the medication to take to help recover faster. Many of these medications come in meter dose inhaler and nebulizer form.

Examples: Albuterol (ProAir®, Proventil®, Ventolin®) and Levalbuterol (Xopenex®)


Anticholinergics

When I was in school for respiratory therapy, the way I remembered what these medications did was by referring to them as “back door bronchodilators.” Why does this make sense? Well, just by the name I know that they open the airways, but just by another means. They relax the muscles that tighten around the airways. “Back door” would help me to remember that typically it takes a little longer to get to a back door of a home, so it takes a little longer for these medications to work than your standard short-acting bronchodilator. (Keeping up with me?) The other awesome benefit to all of you out there that manage excessive mucus is that they also help to block the production of mucus.

Examples: Ipratropium Bromide (Atrovent®), Tiotropium Bromide (Spiriva®), Umeclidinium (Incruse®)


Combination Therapy is widely popular amongst physicians because they can prescribe at least two kinds of medication in one drug. Many times, there is increased expense at the pharmacy with this route of administration, but it ensures that the patient will definitely get both medications and can be performed in half the time for those with busy lifestyles.

Examples of combination short-acting bronchodilators: Combivent Respimat® (Albuterol and Ipratropium Bromide) and DuoNeb® (Albuterol and Ipratropium Bromide)


Controllers (Maintenance Medications)


Long-Acting Bronchodilators

Long-acting bronchodilators are prescribed to help a patient keep their airways open for an extended period of time. They typically function for about 12 hours by relaxing the muscles around the airways. You should never use these types of bronchodilators to get immediate relief from your shortness of breath. Long-acting bronchodilators can come in variety of different forms from dry powder inhalers to a standard inhaler that sprays out.

Examples: Formoterol (Foradil®), Salmeterol (Serevent®), Olodaterol hydrochloride (Striverdi®)


Inhaled Corticosteroids

As another type of inhaled “controller” medication, inhaled corticosteroids help to reduce inflammation in the airways. I often hear my patients tell me that they “don’t know if it is working for them or not.” My response is if you are staying “well” for longer periods of time and are experiencing fewer flare-ups… this medication is working for you! You MUST remember to always rinse your mouth after using inhaled corticosteroids as they can cause thrush which is quite uncomfortable. These medications come in a variety of forms from inhalers to those that can be nebulized.

Examples: Fluticasone propionate (Flovent®), Mometasone furoate (Asmanex®), Budesonide (Pulmicort®), Ciclesonide (Alvesco®), Fluticasone furoate (Arnuity®)


Combination Therapy is available for long-acting bronchodilator therapy with inhaled corticosteroids. (Reminder: rinse your mouth after)

Examples: Fluticasone and Salmeterol (Advair®), Budesonide and Formoterol (Symbicort®), Mometasone and Formoterol (Dulera®), Fluticasone and Vilanterol (Breo®), Fluticasone furoate and umeclidinium and vilanterol (Trelegy®)


Other Types of Controllers

There are other types of maintenance medications that people with lung conditions take to help control inflammation in the lungs. These medications are taking by mouth and can be used in combination with other inhaled medications.

Examples: Roflumilast (Daliresp®) and Montelukast (Singulair®)


Medications Specific for Pulmonary Fibrosis

Medications for pulmonary fibrosis are prescribed for patients with specific types of fibrosis. I know that sounds confusing and a bit unfair but when we look at pulmonary fibrosis as a disease… what is right for one patient just might not be right for the next. Some hope in the form of drug therapy has come out in the last few years that is helping to slow down the progression of pulmonary fibrosis for some patients.

Examples: Nintedanib (Ofev®) an anti-fibrotic medication, Pirfenidone (Esbriet®, Pirfenex®, Pirespa®) an anti-fibrotic and anti-inflammatory medication

Mycophenolate mofetil/mycophenolic acid (Cellcept®) prevents inflammation, Azathioprine (Imuran®) suppresses the immune system


Final Thoughts…

· The examples listed in this blog are just that… examples. There are many more inhaled medications on the market and pharmaceutical companies are constantly innovating.

· Remember to talk with your doctor if you start experiencing side effects that you are concerned about or are causing you discomfort.

· Be open to trying new medications so that you can find the right “cocktail” that will benefit you and your lung condition.

· Always keep a list of your medications with you in your wallet.

· Shop around to reduce prescription costs. I love GoodRx. I took a screenshot of the cost of a ProAir inhaler in my area from their website. I found I could save a chunk of change just getting medications from different pharmacies.



Thanks for Reading!


If you enjoyed this blog, I invite you to check out some of the topics I have covered in the past

8 Winter Breathing Tips for People with Lung Conditions

How to Attend a BIG Event When You Have a Lung Condition

See the Sights. Road Tripping with a Lung Condition


Remember: We are in this TOGETHER!


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:) Christina


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