Bronchodilators are medications taken to improve breathing. They help expand the airways and improve the breathing capacity of patients with bronchial asthma, chronic obstructive pulmonary disease (COPD), emphysema, pneumonia, bronchitis and other lung diseases. They may also be used to treat breathing-related symptoms associated with an allergic reaction.

Bronchodilators also help clean mucus from the lungs to improve breathing. As air passageways are opened, mucus moves more freely because it becomes thin and can be coughed out more easily.

Bronchodilators are sometimes called either “rescue” or “control” medications. Rescue medications are usually short-acting and are used for quick relief from symptoms. They work by relaxing the bands of muscle surrounding the airways. Control medications are long-acting medications taken daily to prevent breathing difficulties from occurring and to prevent long-term damage to the airways. Patients continue to take these medications even when symptoms do not occur.

It is vital to understand and follow all directions for taking bronchodilators, because patients often do not take their medication properly. For instance, many patients stop taking long-acting bronchodilators, which are preventive medications, when symptoms disappear. Long-acting bronchodilators are generally prescribed to be taken daily to be effective. They prevent inflammation and usually do not work to break an acute attack.

Short-acting bronchodilators, on the other hand, are prescribed only for occasional relief of symptoms. Patients who frequently use their inhalers may need to have their treatment regimen altered to include a long-acting bronchodilator.

For instance, an individual who must use a short-acting beta2 agonist more than twice a week to control intermittent asthma may need to begin long-term control therapy, according to the U.S. National Asthma Education and Prevention Program.

Bronchodilators are sometimes used in combination with other drugs to achieve maximum results. For example, an asthma patient might be prescribed an inhaled corticosteroid to control inflammation in conjunction with a long–acting bronchodilator, taken by inhaler, to open narrowed passageways, especially during the night.

Some bronchodilators are available over-the-counter, while others require a prescription. They come in oral (e.g., tablets, capsules, liquids), injected and inhaled forms.

Oral forms of bronchodilators tend to have more side effects because they are delivered in higher doses and absorbed into the bloodstream. Inhaled bronchodilators are directly deposited in the lungs and tend to cause fewer side effects.

Bronchodilators can be inhaled directly into the lungs using the following devices:

• Inhalers. Used primarily to treat asthma, chronic obstructive pulmonary disease (COPD) and other respiratory problems. Inhalers release small amounts of the required drug when breathed in. They can be used to prevent symptoms from occurring or to relieve symptoms.
  
  One of the most common types of drug/inhaler combinations (albuterol in a metered-dose inhaler), is currently being phased out of the United States market due to environmental concerns. The Food and Drug Administration (FDA) has requested that these inhalers be removed from the market by 2009. A new type of inhaler, known as the hydrofluoroalkane-based (HFA) inhaler, offers the same albuterol in a different delivery vehicle (one that does not damage the environment). This will not lead to any significant change as far as the patient is concerned.

• Insufflation cartridges. Provide a greater dose than inhalers.
  
  
• Nebulizers. These devices deliver the largest dose and provide the fastest relief. A face mask or a mouthpiece provides a mixture of compressed air and the specific drug.