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COPD. Online. Patient. Education.

Use, effects and side effects of your medicines

 

Reliever medicines should be used for symptom relief as a rescue medicine for the relief of breathlessness. They are called short-acting (because they work quickly) bronchodilators.


They work by relaxing the muscles around the breathing tubes or airways. This helps to open up the breathing tubes or airways which reduces the obstruction and allows air to flow out of and into the lungs when you breathe – easing your feelings of breathlessness and increasing your ability to exercise.


Relievers often work within minutes of inhalation and their effects last for several hours.


Beta2-agonists (short-acting) and Anticholinergic (short-acting) also known as short-acting muscarinic antagonists (SAMA) are both classes of reliever or broncholdilator medicines.

 

 

Terbutaline (Bricanyl®) given by a Turbuhaler and sometimes by a nebuliser.


Salbutamol (Asmol®, Airomir®, Ventolin®):- given by a spacer and puffer and sometimes a nebuliser.

 

Use

  • Always carry a short-acting reliever with you for acute situations or when doing exercise such as attending a pulmonary rehabilitation program or a Lungs in Action class.
  • If you are using more than your prescribed dose, your condition may be getting worse or you might have an infection. You should see your GP as you may require a longer lasting inhaler or other medicine.

Effects

  • Lasts for up to four hours.
  • Works within minutes to relieve symptoms.
  • Can be taken prior to exercise if needed.

Side effects
  • Headaches, anxiety or nervousness.
  • Nausea.
  • Muscle tremors.
  • Increased or irregular heartbeats.

Ipratropium bromide (Atrovent®)

 

Use

  • Has a slower onset than short-acting beta2-agonists, but it lasts longer.


Effects

  • Relaxes smooth muscles in your lungs and opens up breathing tubes or airways in a different way compared with beta2-agonists.
  • It helps improve quality of life and breathlessness.
  • Lasts for up to six hours.


Side effects

  • Minor adverse effects such as dry mouth, urinary retention and blurred vision are common.
  • Has been shown to increase risk of adverse cardiovascular events.
  • Should NOT be used in conjunction with Spiriva® (tiotropium bromide, Seebri® (glycopyrronium bromide) and Bretaris® (aclidinium bromide).

Maintenance inhalers are bronchodilators too, since they open up the breathing tubes or airways by relaxing the muscles around the breathing tubes or airways in the same way that relievers do. Maintenance bronchodilators usually take longer than relievers to start working, but once you have taken them, their effects last for much longer, usually over a 12 or 24 hour period.


Maintenance medicines will help to reduce your COPD symptoms in the long term and can help to prevent flare ups.


All maintenance inhalers work in one of two different ways to relax the muscles around the breathing tubes or airways. You can be prescribed one type alone, or may receive a combination of both types.


Anticholinergic (long-acting) also known as long-acting muscarinic antagonists (LAMA) and Beta2-agonists (long-acting) are sub-classes of maintenance medicines.

 

Tiotropium (Spiriva®)

Glycopyrronium bromide (Seebri®)

Aclidinium bromide (Bretaris®)

Umeclidinium (Incruse Ellipta®)


Use

  • Inhale once daily only. (Bretaris®, twice daily).
  • Use with the HandiHaler®.
  • The capsule should not be swallowed.

Effects

  • Relaxes smooth muscles in your lungs and opens the breathing tubes or airways.
  • Lasts for 12 to 24 hours depending on the medicine.
  • Improves your lung function which can improve your quality of life.
  • Helps to prevent flare ups.

 

 

Side effects

  • Dry mouth, urinary retention and blurred vision, diarrhoea, indigestion, tooth decay.
  • Use with caution if you have a prostate problem.

      

 

Eformoterol (Oxis®, Foradile®)

Salmeterol (Serevent®)

Indacaterol (Onbrez®)


Use
  • Do not use to treat an acute situation (use a short-acting reliever instead).
  • Should be taken twice a day (morning and night) except for Onbrez® which is taken once a day.
 

Effects

  • Relaxes smooth muscles in your lungs.
  • Improves your lung function which can improve your quality of life.
  • Onbrez® lasts up to 24 hours and is fast acting.
  • Serevent® takes 10 to 20 minutes to take effect and lasts up to 12 hours.
  • Oxis® is fast acting and lasts up to 12 hours.

Side effects

  • Tremor, headache and a rapid heartbeat.
 
These medicines are also discussed in the reliever section as it may be used as both reliever and maintenance.

 

Ipratropium bromide (Atrovent®)


Use

  • In addition to being prescribed as a short-acting reliever medicine, some people are prescribed ipratropium bromide as a regular maintenance medicine.

 

 

Indacaterol / glycopyrronium bromide (Ultibro®)

Umeclidinium/Vilanterol (Anoro Ellipta®)
 

Use

  • a combination inhaled long-acting muscarinic receptor antagonist/long-acting beta2-adrenergic agonist (LAMA/LABA).
  • Following inhalation both compounds act locally on airways to produce bronchodilation by separate mechanisms.
Effects

 

  • Works by relaxing the muscles around the airways in the lungs so they open up to make breathing easier.
  • Must be used regularly to be effective. It does not work immediately and should not be used to relieve sudden shortness of breath. If sudden breathing problems occur, use your quick-relief inhaler as prescribed.
Side Effects

 

  • Headaches, anxiety or nervousness.
  • Nausea.
  • Muscle tremors
  • Increased or irregular heartbeats