COPD & Emphysema Support Group
COPD is a progressive disease characterized by airflow obstruction or limitation. Emphysema is characterized by loss of elasticity of the lung tissue, destruction of structures supporting the alveoli and of capillaries feeding the alveoli. Both have symptoms that include shortness of breath, among other respiratory troubles. If you are a COPD or Emphysema sufferer, join...
There seems to be a lot of confusion regarding Bronchodilators VS corticosteroids. I am submitting a brief description of each, followed by some information on the most popular brand names of each. I hope this helps. Gary
Bronchodilators:
Bronchodilators are medicines used to relax the smooth muscle around the airways to "open up" the lungs. They can relieve spasm in these muscles as well. This group of medicines is used to treat asthma, chronic obstructive pulmonary disease, emphysema, bronchitis and other causes of bronchospasm. They can be administered by inhaler, nebulizer, oral pills or injection.
Albuterol
Albuterol is a short-acting drug commonly known by the brand names Ventolin or Proventil. It begins to work quickly, but its effects are not particularly long lasting. Because of these properties, it is often called a "rescue" medication. Possible side effects include jitteriness, shakiness, increased heart rate, lightheadedness and headache. Rarely, it may cause a paradoxical bronchospasm and worsening of the condition it is used to treat. Albuterol has FDA approval for use in those over age 4.
Levalbuterol
This drug is very similar to albuterol in its chemistry and its actions. It is sold as a generic or by the brand name Xopenex. It is also short acting. This bronchodilator is inhaled and is available in a nebulizer solution or in an inhaler. Levalbuterol is approved for use down to age 4.
Pirbuterol
This drug is related to both Albuterol and Levalbuterol and has similar properties. It is only available as the brand name Maxair in an "autohaler," which is breath activated. Maxair is not to be used by children.
Salmeterol
This medicine, available under the brand name Serevent, is a long-acting bronchodilator. It takes longer to have effect, but lasts longer than others. For this reason, it is not to be used in "rescue" situations. It comes in a Diskus inhaler alone or in combination with another medicine. Increased heart rate, tremor, nervousness and headache may occur. Approval for use down to age 4 years has been obtained.
Formoterol
This bronchodilator is sold under the brand name Foradil or Perforomist. It is also a long-acting medicine. It comes in a dry powder inhaler or in solution for use in a nebulizer. Due to its mechanism of action, this drug may cause tremors, a racing heart, insomnia, lightheadedness or headaches. Use in children as young as age 5 is FDA approved.
Theophylline
Considered a long-acting bronchodilator, Theophylline is taken orally. Possible adverse reactions are irritability, stomach upset, heart palpitations or rhythmn disturbances, or seizures. There are many drug interactions to be concerned about. Use in children down to age 6 weeks is FDA approved.
Aformoterol
A nebulized medicine available under the brand name Brovana, Aformoterol is a long acting bronchodilator. It has the same side effect profile previously discussed for Salmeterol and is not approved for children.
Ipratropium
A different mechanism of action sets Ipratropium apart, although it is still considered a short-acting bronchodilator. It is available in an inhaler or solution for nebulization. Ipratropium is frequently used in combination with Albuterol. Possible side effects include cough, dry mouth and blurred vision. FDA approval goes down to age 12 years.
Tiotropium
Tiotropium, sold under the brand name Spiriva, is longer acting than Ipratropium. It comes in capsules for use in a Handihaler device. More frequent adverse reactions include cough and dry mouth, although a slowing of the heart conduction system is possible. Use in children is not FDA approved.
---------------------------------------------------------------------------------------------
Corticosteroids:
Steroids or glucocorticosteroids are medications used in the treatment of COPD that control swelling. They are called anti-inflammatory drugs because they decrease swelling in the airways of the lungs. These drugs are not the same as anabolic steroids, which are used by "body builders" to build muscles.
Oral corticosteroids may be used to treat chronic obstructive pulmonary disease (COPD) Click here to see more information. when symptoms rapidly get worse (COPD exacerbation), especially when there is increased mucus production.
Inhaled corticosteroids may be used to treat stable symptoms of COPD or symptoms that are slowly getting worse. Inhaled corticosteroids may decrease the number of COPD exacerbations in people with severe COPD, particularly those with chronic bronchitis
Corticosteroids may be useful for people who have asthma Click here to see more information. as a component of their disease.
Advair
Advair is a combination of two medications -- fluticasone, a corticosteroid, and salmeterol, a long-acting, beta-agonist bronchodilator. Advair is used for maintenance treatment of COPD.
Symbicort
Originally used for the treatment of asthma, Symbicort was approved by the Food and Drug Administration in February 2009, for maintenance treatment of COPD. Symbicort contains formotorol, a long-acting, beta-agonist bronchodilator, and budesonide, a corticosteroid.
Prednisone
Prednisone is an oral, synthetic (man-made) corticosteroid used for suppressing the immune system and inflammation. It has effects similar to other corticosteroids such as triamcinolone (Kenacort), methylprednisolone (Medrol), prednisolone (Prelone) and dexamethasone (Decadron). These synthetic corticosteroids mimic the action of cortisol (hydrocortisone), the naturally-occurring corticosteroid produced in the body by the adrenal glands. Corticosteroids have many effects on the body, but they most often are used for their potent anti-inflammatory effects, particularly in those conditions in which the immune system plays an important role. Such conditions include arthritis, colitis, asthma, bronchitis, certain skin rashes, and allergic or inflammatory conditions of the nose and eyes. Prednisone is inactive in the body and, in order to be effective, first must be converted to prednisolone by enzymes in the liver. Therefore, prednisone may not work as effectively in people with liver disease whose ability to convert prednisone to prednisolone is impaired
Bronchodilators:
Bronchodilators are medicines used to relax the smooth muscle around the airways to "open up" the lungs. They can relieve spasm in these muscles as well. This group of medicines is used to treat asthma, chronic obstructive pulmonary disease, emphysema, bronchitis and other causes of bronchospasm. They can be administered by inhaler, nebulizer, oral pills or injection.
Albuterol
Albuterol is a short-acting drug commonly known by the brand names Ventolin or Proventil. It begins to work quickly, but its effects are not particularly long lasting. Because of these properties, it is often called a "rescue" medication. Possible side effects include jitteriness, shakiness, increased heart rate, lightheadedness and headache. Rarely, it may cause a paradoxical bronchospasm and worsening of the condition it is used to treat. Albuterol has FDA approval for use in those over age 4.
Levalbuterol
This drug is very similar to albuterol in its chemistry and its actions. It is sold as a generic or by the brand name Xopenex. It is also short acting. This bronchodilator is inhaled and is available in a nebulizer solution or in an inhaler. Levalbuterol is approved for use down to age 4.
Pirbuterol
This drug is related to both Albuterol and Levalbuterol and has similar properties. It is only available as the brand name Maxair in an "autohaler," which is breath activated. Maxair is not to be used by children.
Salmeterol
This medicine, available under the brand name Serevent, is a long-acting bronchodilator. It takes longer to have effect, but lasts longer than others. For this reason, it is not to be used in "rescue" situations. It comes in a Diskus inhaler alone or in combination with another medicine. Increased heart rate, tremor, nervousness and headache may occur. Approval for use down to age 4 years has been obtained.
Formoterol
This bronchodilator is sold under the brand name Foradil or Perforomist. It is also a long-acting medicine. It comes in a dry powder inhaler or in solution for use in a nebulizer. Due to its mechanism of action, this drug may cause tremors, a racing heart, insomnia, lightheadedness or headaches. Use in children as young as age 5 is FDA approved.
Theophylline
Considered a long-acting bronchodilator, Theophylline is taken orally. Possible adverse reactions are irritability, stomach upset, heart palpitations or rhythmn disturbances, or seizures. There are many drug interactions to be concerned about. Use in children down to age 6 weeks is FDA approved.
Aformoterol
A nebulized medicine available under the brand name Brovana, Aformoterol is a long acting bronchodilator. It has the same side effect profile previously discussed for Salmeterol and is not approved for children.
Ipratropium
A different mechanism of action sets Ipratropium apart, although it is still considered a short-acting bronchodilator. It is available in an inhaler or solution for nebulization. Ipratropium is frequently used in combination with Albuterol. Possible side effects include cough, dry mouth and blurred vision. FDA approval goes down to age 12 years.
Tiotropium
Tiotropium, sold under the brand name Spiriva, is longer acting than Ipratropium. It comes in capsules for use in a Handihaler device. More frequent adverse reactions include cough and dry mouth, although a slowing of the heart conduction system is possible. Use in children is not FDA approved.
---------------------------------------------------------------------------------------------
Corticosteroids:
Steroids or glucocorticosteroids are medications used in the treatment of COPD that control swelling. They are called anti-inflammatory drugs because they decrease swelling in the airways of the lungs. These drugs are not the same as anabolic steroids, which are used by "body builders" to build muscles.
Oral corticosteroids may be used to treat chronic obstructive pulmonary disease (COPD) Click here to see more information. when symptoms rapidly get worse (COPD exacerbation), especially when there is increased mucus production.
Inhaled corticosteroids may be used to treat stable symptoms of COPD or symptoms that are slowly getting worse. Inhaled corticosteroids may decrease the number of COPD exacerbations in people with severe COPD, particularly those with chronic bronchitis
Corticosteroids may be useful for people who have asthma Click here to see more information. as a component of their disease.
Advair
Advair is a combination of two medications -- fluticasone, a corticosteroid, and salmeterol, a long-acting, beta-agonist bronchodilator. Advair is used for maintenance treatment of COPD.
Symbicort
Originally used for the treatment of asthma, Symbicort was approved by the Food and Drug Administration in February 2009, for maintenance treatment of COPD. Symbicort contains formotorol, a long-acting, beta-agonist bronchodilator, and budesonide, a corticosteroid.
Prednisone
Prednisone is an oral, synthetic (man-made) corticosteroid used for suppressing the immune system and inflammation. It has effects similar to other corticosteroids such as triamcinolone (Kenacort), methylprednisolone (Medrol), prednisolone (Prelone) and dexamethasone (Decadron). These synthetic corticosteroids mimic the action of cortisol (hydrocortisone), the naturally-occurring corticosteroid produced in the body by the adrenal glands. Corticosteroids have many effects on the body, but they most often are used for their potent anti-inflammatory effects, particularly in those conditions in which the immune system plays an important role. Such conditions include arthritis, colitis, asthma, bronchitis, certain skin rashes, and allergic or inflammatory conditions of the nose and eyes. Prednisone is inactive in the body and, in order to be effective, first must be converted to prednisolone by enzymes in the liver. Therefore, prednisone may not work as effectively in people with liver disease whose ability to convert prednisone to prednisolone is impaired
do you think the confusion is because some of the inhalers mix the steroid with the bronchodialator?
personally, i get confused with the long acting vs short acting inhalers.
i know the ones i take (spiriva & albutrol nebulizer) which both are "premeasured" so there is no 1 puff or 5 puffs; my dr knows he has to keep things simple for me LOL
When we use oral steroids ,... they enter the digestive tract & are absorbed by many tissues in the body. That is why docs use the inhaler protocol more often for routine administration.
spiriva is expensive, but the fact that it it is only done once a day is the perk for me (& why would i do spiriva 4 times a day if i can do it once a day or every other day?)
i have the albuterol that i can do 4 times a day yeah---& it is rather cheap comparably ;)
hey gary question; if spiriva & albuterol are the same thing---how come i can do my spiriva & "feel" okay, but the albuterol makes my heart race & i get real shaky and feel like i'm going to have a heart attack when i do it?
(see, in my "simple mind"; the spiriva lasts longer so should have the more "feirce" after affects than the short acting albuterol, not vice versa like they do to me)
Ipratropium
A different mechanism of action sets Ipratropium apart, although it is still considered a short-acting bronchodilator. It is available in an inhaler or solution for nebulization. Ipratropium is frequently used in combination with Albuterol. Possible side effects include cough, dry mouth and blurred vision. FDA approval goes down to age 12 years.
Tiotropium
Tiotropium, sold under the brand name Spiriva, is longer acting than Ipratropium. It comes in capsules for use in a Handihaler device. More frequent adverse reactions include cough and dry mouth, although a slowing of the heart conduction system is possible. Use in children is not FDA approved.
Albuterol
Albuterol is a short-acting drug commonly known by the brand names Ventolin or Proventil. It begins to work quickly, but its effects are not particularly long lasting. Because of these properties, it is often called a "rescue" medication. Possible side effects include jitteriness, shakiness, increased heart rate, lightheadedness and headache. Rarely, it may cause a paradoxical bronchospasm and worsening of the condition it is used to treat. Albuterol has FDA approval for use in those over age 4.
Onbrez and Spiriva: A Winning Combination
Many of you use the long-acting, anticholinergic bronchodilator Spiriva for daily maintenance treatment of COPD. According to a recent study, combining Spiriva Handihaler with the Onbrez Breezhaler works better to improve lung function than just using Spiriva alone.
Onbrez is a relatively new, long-acting beta agonist bronchodilator manufactured by the drug company, Novartis. So new, in fact, it has not yet met with FDA approval in the United States. It is currently being used however, in the European Union as well as in 50 other countries. The FDA advisory committee will be discussing its approval for the US market in March of this year.
While Onbrez and Spiriva are both bronchodilators, each has a different mode of action. Both drugs open up the airways and make breathing easier for people with COPD. Combining bronchodilators of different classes is recommended by the Global Initiative for Obstructive Lung Disease (GOLD) as part of the standard treatment guidelines for COPD
.Comments (23)