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COPD - quick-relief drugs

COPD - quick-relief drugs; Chronic obstructive pulmonary disease - control drugs; Chronic obstructive airways disease - quick-relief drugs; Chronic obstructive lung disease - quick-relief drugs; Chronic bronchitis - quick-relief drugs; Emphysema - quick-relief drugs; Bronchitis - chronic - quick-relief drugs; Chronic respiratory failure - quick-relief drugs; Bronchodilators - COPD - quick-relief drugs; COPD - short-acting beta agonist inhaler

Quick-relief medicines for chronic obstructive pulmonary disease (COPD) work quickly to help you breathe better. You take them when you are coughing, wheezing, or having trouble breathing, such as during a flare-up. For this reason, they are also called rescue drugs.

The medical name of these drugs is bronchodilators, meaning medicines that open the airways (bronchi). They relax the muscles of your airways and open them up for easier breathing. You and your doctor can make a plan for the quick-relief drugs that work for you. This plan will include when you should take your medicine and how much you should take.

Follow instructions on how to use your medicines the right way.

Make sure you get your medicine refilled before you run out.

Quick-relief Beta-agonist Inhalers

Quick-relief beta-agonists help you breathe better by relaxing the muscles of your airways. They are short-acting, which means they stay in your system only for a short time.

Some people take them just before exercising. Ask your doctor if you should do this.

If you need to use these drugs more than 3 times a week, or if you use more than one canister a month, your COPD probably is not under control. You should call your doctor.

Kinds of Quick-relief Beta-agonists

Quick-relief beta-agonists inhalers include:

  • Albuterol (ProAir HFA; Proventil HFA; Ventolin HFA)
  • Levalbuterol (Xopenex HFA)
  • Albuterol and ipratropium (Combivent)

Most of the time, these medicines are used as metered dose inhalers (MDI) with a spacer. Sometimes, especially if you have a flare-up, they are used with a nebulizer.

Side effects might include:

  • Anxiety.
  • Tremor.
  • Restlessness.
  • Headache.
  • Fast or irregular heartbeats. Call your doctor right away if you have this side effect.

Some of these medicines also exist in pills, but the side effects are a lot more significant, so they are very rarely used that way.

Oral Steroids

Oral steroids (also called corticosteroids) are medicines you take by mouth, as pills, capsules, or liquids. They are not quick-relief medicines, but are often given for 7 to 14 days when your symptoms flare-up. Sometimes you might have to take them for longer.

Oral steroids include:

  • Methylprednisolone
  • Prednisone
  • Prednisolone

References

Anderson B, Brown H, Bruhl E, et al. Institute for Clinical Systems Improvement website. Health Care Guideline: Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). 10th edition. www.icsi.org/wp-content/uploads/2019/01/COPD.pdf. Updated January 2016. Accessed February 28, 2018.

Han MK, Lazarus SC. COPD: clinical diagnosis and management. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 44.

Rabe KF, Watz H. Chronic obstructive pulmonary disease. Lancet. 2017;389(10082):1931-1940. PMID: 28513453 www.ncbi.nlm.nih.gov/pubmed/28513453.

Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management and prevention of chronic obstructive lung disease 2017 report: GOLD Executive Summary. Respirology. 2017;22(3):575-601. PMID: 28150362 www.ncbi.nlm.nih.gov/pubmed/28150362.

  • Inhaler with spacer - adults

    Animation

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    Inhaler with spacer - adults - Animation

    If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. A spacer device will help. The spacer connects to the inhaler mouthpiece, and the medicine goes into the spacer tube first. This allows you to breathe in the medicine more easily. Using a spacer wastes a lot less medicine than spraying the medicine directly into your mouth. It also makes it less important to get the exact timing for activating the inhaler while taking in a breath. These are instructions for using an inhaler with a spacer. First off, if you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for when and how to do this. Take the caps off the inhaler and spacer. Look inside each mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Attach the inhaler mouthpiece to the open end of the spacer and hold it upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the spacer mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the spacer so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Your spacer may have a whistle that sounds if you breathe in too fast. Take the spacer out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the caps back on the inhaler and spacer. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler and spacer operating correctly, you need to keep them clean. Follow the manufacturer's instructions for when and how often to clean your inhaler and spacer. Using your inhaler with a spacer the right way ensures you get the medicine you need. It's a good idea to bring your inhaler and spacer to your medical appointments. That way your health care provider can make sure you are using them correctly.

  • Inhaler with spacer - adults

    Animation

  •  

    Inhaler with spacer - adults - Animation

    If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. A spacer device will help. The spacer connects to the inhaler mouthpiece, and the medicine goes into the spacer tube first. This allows you to breathe in the medicine more easily. Using a spacer wastes a lot less medicine than spraying the medicine directly into your mouth. It also makes it less important to get the exact timing for activating the inhaler while taking in a breath. These are instructions for using an inhaler with a spacer. First off, if you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for when and how to do this. Take the caps off the inhaler and spacer. Look inside each mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Attach the inhaler mouthpiece to the open end of the spacer and hold it upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the spacer mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the spacer so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Your spacer may have a whistle that sounds if you breathe in too fast. Take the spacer out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the caps back on the inhaler and spacer. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler and spacer operating correctly, you need to keep them clean. Follow the manufacturer's instructions for when and how often to clean your inhaler and spacer. Using your inhaler with a spacer the right way ensures you get the medicine you need. It's a good idea to bring your inhaler and spacer to your medical appointments. That way your health care provider can make sure you are using them correctly.

    A Closer Look

     

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    Review Date: 2/18/2018

    Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 02-25-19: Editorial update.

    The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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