How Are Inhalers Used to Treat Bronchitis?

Inhalers deliver medicines that can improve your ability to breathe. In bronchitis, they are usually prescribed only for chronic bronchitis and severe cases of acute bronchitis. Inhalers contain medicines that treat bronchitis symptoms in different ways and have various side effects.

Let’s review bronchitis first and then dive into the different inhaler treatments commonly prescribed for bronchitis.

What Is Bronchitis?

During bronchitis, the bronchi, the tubes that lead from your mouth to your lungs, swell up and start producing protective mucus that triggers coughing. Bronchitis symptoms include: 

• A cough that keeps you up at night
• A sore or tight chest from coughing
• A sore throat from coughing
• Lingering tiredness, headaches, and body aches 
• A low-grade fever

There are two main kinds of bronchitis—acute and chronic. They differ based on what has triggered the swelling in the bronchi.

A viral or bacterial infection usually causes acute bronchitis. Your illness will likely start with a cold that lasts a few days, then develop into a long-lasting cough. The cough should be improving by around three weeks after the initial cold. Acute bronchitis is also called a chest cold.

Chronic bronchitis is usually caused by exposure to pollutants or irritants, like tobacco smoke. It can get worse over time, and so it needs to be treated. It is a type of chronic obstructive pulmonary disease (COPD).

Chronic bronchitis is more likely to cause wheezing and a whistling or squeaking sound while breathing. While chronic bronchitis itself isn’t contagious, it can lead to frequent colds and flu and other respiratory illnesses that can spread to other people.

Diagnosis

If you think you have acute bronchitis caused by an infection, you probably don’t need to see a healthcare provider. These infections usually heal on their own and get better without prescription treatment or intervention. There are a couple of instances in which you probably should seek out care for acute bronchitis:

• A temperature above 100.4 degrees Fahrenheit
• Bloody mucus comes up when coughing
• Wheezing or trouble breathing
• More than three weeks of symptoms without improvement 
• A cough that goes away and comes back

For chronic bronchitis, you’ll want to see a healthcare provider and get treatment before your symptoms get worse and limit your breathing further. 

When you see a healthcare provider for either chronic bronchitis or complications of acute bronchitis, they will do a visual examination of your throat, feel your lymph nodes in your neck for swelling, and listen to your lungs with their stethoscope.

They may do lab tests, including blood tests and lung function tests, and imaging tests, like a chest X-ray or computed tomography (CT) scan to check if bronchitis has become pneumonia. They’ll ask you about your medical history, family history, and your symptoms.

Treatment Options

Treatment for acute bronchitis typically includes rest, drinking fluids, and using a humidifier to keep your breathing passages clear. If your coughing is disrupting sleep, you can use cough suppressants or expectorants (formulations that contain the active ingredient guaifenesin) from the drugstore to relieve it.

For a sore throat, you can suck on lozenges, hard candy, or ice pops. If you have pain or a fever, try over-the-counter pain relievers to feel better, including:

• Aspirin
• Tylenol (acetaminophen)
• Advil (ibuprofen)
• Aleve (naproxen)

Antibiotics are discouraged for acute bronchitis because only a small percentage of cases are caused by bacteria rather than viruses. When appropriate, an antibiotic might help your body fight off the bacteria causing the infection but won’t help break up mucus or soothe night coughing.

If you have excessive wheezing, trouble breathing, or have chronic bronchitis, your healthcare provider may prescribe you one or more inhalers as a treatment option for your bronchitis. Inhalers deliver medicine right into your lungs, where they can help reduce swelling and open up your bronchi.

There are various options for inhalants that your healthcare provider may prescribe, based on your condition, your infection, and your long-term prognosis. These inhaled medications act in different ways and have different side effects.

Most of these inhaled medications are prescribed for chronic bronchitis or COPD, which gets progressively more severe and can be deadly. Which medications you’re prescribed will depend on how severe your chronic bronchitis is.

Beta-2 Agonists

Short-acting beta-2 agonists like albuterol may be used for bronchitis when the patient is wheezing or having trouble breathing. This might happen with either chronic or acute bronchitis.

Beta-2 agonists relieve the symptoms of wheezing and trouble breathing by acting as a bronchodilator—widening the opening of the bronchi so they let more air into your lungs.

A Cochrane report updated in 2015 suggests that regular prescription of beta-2 agonists isn’t useful for most acute bronchitis patients and is not useful in children with bronchitis. They do seem to help patients with wheezing or whose swollen bronchi are obstructing their breathing. They can help these patients breathe easier.

Side effects of these medications include tremors, shakiness, and nervousness.

Inhaled Corticosteroids 

Inhaled corticosteroids are sometimes prescribed for chronic bronchitis and COPD. They are not used as monotherapy for COPD. They are used in conjunction with long-acting bronchodilators for severe disease (FEV1 <50%) or patients with frequent exacerbations.

They work by reducing inflammation in the lungs, preventing symptoms like wheezing, shortness of breath, coughing, and tightness in the chest. 

A review found that high-dose inhaled corticosteroids can improve symptoms in those with chronic bronchitis as a part of COPD. They can slow down the rate of decline in quality of life and reduce the frequency of attacks. But they do not have a consistent long-term benefit in decreasing the loss of breathing capacity or risk of death.

Side effects of inhaled steroids include thrush in the mouth, hoarseness, and increased risk of developing pneumonia.

Long-Acting Beta-2 Agonists

Long-acting beta-2 agonists are used for moderate-to-severe chronic bronchitis when it interferes with the ability of the patient to breathe. Instead of the short-acting beta-2 agonists, which are used only during an attack, these prescription inhalers are used daily to prevent flare-ups.

They act on the muscles in the lungs to relax them, opening the airways. Long-acting beta-2 agonists are often prescribed in combination with inhaled steroids for daily preventive treatment for chronic bronchitis and COPD.

Side effects of long-acting beta-2 agonists are similar to those of short-acting beta-2 agonists. They include tremors, shakiness, and nervousness, along with headache, increased heart rate, dizziness, anxiety, and a rash.

Nebulizers 

Sometimes inhaled medications given in the hospital or at home are delivered through a nebulizer, which lets a patient inhale the medication as a mist. A nebulizer can provide medication through a mask and doesn’t require the coordinated breathing of an inhaler.

They’re sometimes recommended for asthma, chronic bronchitis, and COPD patients who have a very low ability to breathe in. A nebulizer could deliver any of the above inhaler medications if that works better for you. The medications would have the same side effects as taken through an inhaler.

A Word From Verywell

Cases of acute bronchitis usually clear up without these types of medications. Chronic bronchitis may be managed in a number of ways by a health professional, which is why it’s important to maintain a relationship with your provider and manage your condition appropriately.

Lifestyle changes, like quitting smoking or reducing your exposure to secondhand smoke or other irritants, can also help prevent your chronic bronchitis from getting worse and reduce your need for inhalers and other treatments.

Physical activity can help strengthen your lungs, so talk to your healthcare provider about your options. Prevent future infections by getting vaccines for the flu and pneumonia.