Bronchodilators Health Article

Special conditions

People with certain medical conditions or who are taking certain other medicines can have problems if they use bronchodilators. Before using these drugs, be sure to let the physician know about any of these conditions:

ALLERGIES. Anyone who has had unusual reactions to any bronchodilator or an inhaled form of any other drug in the past should let his or her physician know before taking the drugs again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.

Patients who are allergic to soybeans, soy lecithin, peanuts, or drugs based on atropine should not use the bronchodilator ipratropium (Atrovent).

PREGNANCY. In studies of laboratory animals, some bronchodilators cause birth defects or miscarriage when the animals are given doses many times the usual human dose. Whether these drugs cause such problems in humans in unknown. Any woman who is pregnant or plans to become pregnant should check with her physician before using a bronchodilator.

BREASTFEEDING. Some bronchodilators pass into breast milk. Breastfeeding mothers should check with their physicians before using bronchodilators.

OTHER MEDICAL CONDITIONS. Before using bronchodilators, people with any of these medical problems should make sure their physicians are aware of their conditions:

• glaucoma
• brain damage

• convulsions (seizures)—recently or anytime in the past
• mental illness
• parkinson's disease
• diabetes
• heart or blood vessel diseases
• rapid or irregular heartbeat
• high blood pressure
• overactive thyroid
• enlarged prostate
• obstruction of the neck of the bladder

USE OF CERTAIN MEDICINES. Using bronchodilators with certain other drugs may affect the way the drugs work or may increase the chance of side effects.

Side effects

Some patients have a dry or irritated throat or a dry mouth after using bronchodilators. To help prevent these problems, gargle and rinse the mouth or take a sip of water after each dose.

The most common side effects are nervousness or restlessness and trembling. These problems usually go away as the body adjusts to the drug and do not require medical treatment. Less common side effects, such as bad taste in the mouth, coughing, dizziness or lightheadedness, drowsiness, headache, sweating, fast or pounding heartbeat, muscle cramps or twitches, nausea, vomiting, diarrhea, sleep problems and weakness also may occur and do not need medical attention unless they do not go away or they interfere with normal activities.

More serious side effects are not common, but may occur. If any of the following side effects occur, check with the physician who prescribed the medicine as soon as possible:

• chest pain or discomfort
• irregular or fluttery heartbeat
• unusual bruising
• hives or rash
• swelling
• wheezing or other breathing problems
• numbness in the hands or feet
• blurred vision

Other side effects are possible. Anyone who has unusual symptoms after using a bronchodilator should get in touch with his or her physician.

Interactions

Bronchodilators may interact with a number of other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes these drugs should let the physician know all other medicines he or she is taking. Among the drugs that may interact with bronchodilators are:

• monoamine oxidase inhibitors (MAO inhibitors) such as phenelzine (Nardil) and tranylcypromine (Parnate), used to treat depression
• other bronchodilators
• tricyclic antidepressants such as amitriptyline (Elavil) and imipramine (Tofranil)
• beta blockers such as propranolol (Inderal) and atenolol (Tenormin), used to control high blood pressure
• digitalis medicines, used to treat heart conditions, such as digoxin (Lanoxin)
• drugs, such as certain diuretics (water pills), that lower potassium levels
• ergoloid mesylates such as Hydergine, used to treat symptoms of Alzheimer's disease or multiple small stokes
• ergotamine (Cafergot, Ergostat, and other brands), used to treat migraine and cluster headaches
• the antidepressant maprotiline (Ludiomil)

The list above does not include every drug that may interact with bronchodilators. Be sure to check with a physician or pharmacist before combining bronchodilators with any other prescription or nonprescription (overthe-counter) medicine.

PERIODICALS

Fackelmann, Kathy A. "Anti-inflammatory Drugs May Quell Asthma." Science News (26 Sept. 1992): 197.

ORGANIZATIONS

Asthma and Allergy Foundation of America. 1233 20th Street, NW, Suite 402, Washington, DC 20036. (800) 727-8462. <http://www.aafa.org>.

American Academy of Allergy, Asthma, and Immunology. 611 East Wells St., Milwaukee, WI 53202. (800) 822-2762. <http://www.aaaai.org>.

National Heart, Lung and Blood Institute. P.O. Box 30105, Bethesda, MD 20824-0105. (301) 251-1222. <http://www.nhlbi.nih.gov>.

Nancy Ross-Flanigan