Just when you think you’ve gotten over that respiratory infection, bronchitis hits. The coughing, chest soreness, and fatigue can really get you down.
While acute bronchitis will usually go away without prescription treatments, chronic or an especially nasty case of acute bronchitis may require some extra help.
We explain inhaled treatments for bronchitis, including nebulizer and inhaler treatments, and how they may help.
Inhalers are medications that are delivered through the mouth and to the lungs.
Usually this is a device with a short mouthpiece that connects to a small canister you press down on. When you press down and inhale, the medication enters your mouth and goes down into your lungs.
A doctor may prescribe a few different types of inhaler medications for bronchitis. These include the following:
Some of the most common inhaler medications are short-acting beta-2 agonists. These include medications like albuterol and salbutamol.
Doctors prescribe beta-2 agonists to treat:
- chronic obstructive pulmonary disease (COPD)
- severe coughing that can come with acute bronchitis
These medications work by relaxing airway passages in the lungs, which can make it easier to breathe.
They concluded that there’s little evidence to support the use of beta-2 agonists in adults with acute bronchitis.
However, they did find that inhalers helped people who tended to wheeze frequently, even when they weren’t sick.
Inhaled corticosteroids help to reduce airway inflammation. This can be helpful when you have bronchitis, because it’s usually after an upper respiratory infection and your lungs are already very irritated.
These medications won’t relieve a wheezing attack immediately, but they can help to reduce:
- airway swelling
- excess mucus
- tight airways
Examples of inhaled corticosteroids doctors prescribe include:
Long-acting beta-2 agonists (LABAs)
These medications are similar to short-acting beta-2 agonists like albuterol. They aren’t meant for acute attacks of wheezing, but rather reduce the risk of wheezing all day.
Examples of LABAs include arformoterol tartrate (Brovana) and formoterol fumarate (Oxeze, Foradil).
Doctors usually prescribe these with inhaled corticosteroids.
Nebulizer treatments are another form of inhaled medications. Instead of a short mouthpiece, nebulizer treatments usually have a longer mouthpiece and an air compressor that helps convert the medication to a fine mist.
Doctors often prescribe nebulizers to children who may have a harder time using an inhaler properly.
Instead of having to time the pumps to breathe medication in, a person just takes deep breaths in and out to take in the medication.
Nebulizers are also useful for people who may require larger amounts of inhaled medications, such as those for:
- acute asthma attacks
A doctor would usually prescribe nebulized medications to treat acute bronchitis in children or for chronic bronchitis in adults.
Examples of nebulized medications include:
- Long-acting beta-2 agonists (LABAs). These medications are usually the same as those available for inhalers.
- Long-acting muscarinic agents (LAMAs). These medications work on different receptors in the lungs than beta-agonists to help open up the airways so you can breathe better. Examples of these medicines include umeclinium (Ellipta) and tiotropium (HandiHaler, Respimat).
- Short-acting beta-agonists (SABAs). Like with traditional inhalers, a person can use albuterol in a nebulizer. These are mostly for acute attacks in bronchitis, such as wheezing.
- Short-acting muscarinic antagonists (SAMAs). These are medications like ipratropium bromide (Atrovent). Doctors prescribe them to treat chronic bronchitis and COPD.
Many of these medications are available in combination, such as SABA-SAMA or LABA-LAMA.
Nebulized medications may not be as good a fit for adults without COPD, because nebulizers require special equipment and teaching to use.
Ideally, a person with acute bronchitis wouldn’t need this type of equipment.
In addition to nebulizers and inhalers, some people may inhale warm, humidified air (steam) at home to improve their breathing.
Sometimes cold air can irritate the lungs and worsen coughing when you have bronchitis. Warm, moist air may help you feel better and reduce coughing.
Here are some ways you can incorporate steam or mist therapy into your bronchitis treatments:
- inhale steam from a bowl of boiling water, while hovering at least 8 to 12 inches away with a towel over your head to hold the steam in
- take a hot shower
- use a humidifier in your room, but be sure to carefully clean it after use
Many drugstores also sell plugin steam inhalers.
The side effects from inhalers and nebulizer treatments depend upon the type used. Examples of side effects include the following:
- Beta-2 agonists may cause tremors, nervousness, and shakiness.
- Corticosteroids can causesore mouth, cough, hoarse voice, or nosebleeds. Oral thrush can develop if a person doesn’t rinse their mouth out after use.
- LABAs can cause heart palpitations and tremors.
- LAMAs may cause constipation, dry mouth, and urinary retention.
If you experience any of these when you use an inhaler or nebulizer, talk to your doctor about ways to minimize these side effects. You can also find out if other medications are available.
They may suggest using a spacer device, which maximizes the delivery of the medication to the lungs. This minimizes the settling of medication to the back of the throat, which can lead to side effects.
With treatment and rest, you’ll ideally recover within about 1 to 2 weeks. It may take a bit longer for some people.
If your symptoms, especially your cough, persist beyond 3 weeks, consider scheduling another appointment with your doctor.
A doctor can evaluate you for other potential coughing causes, such as:
You should talk with a doctor if you have a cough that persists after an upper respiratory infection, and it keeps you from completing everyday activities or starts to make your chest hurt.
If you have a fever that accompanies your symptoms, your infection may be bacterial. A doctor can prescribe antibiotics that can help bronchitis go away.
If your cough persists after 3 weeks, you may need to make another appointment with your doctor. Bronchitis will usually subside by this time, so you could have another medical condition.
Sometimes, bronchitis can lead to pneumonia. This is a severe lung infection.
Seek emergency medical treatment if you have worsening symptoms like:
- shortness of breath
- blue-tinted lips or fingernails
Doctors usually treat bronchitis by treating its symptoms.
If your symptoms include wheezing and coughing, your doctor may prescribe an inhaler or nebulizer. These may help you manage your symptoms until you start feeling better.