Comprehensive Guide to Breathing Treatments : Which One is Right for You?

Most individuals breathe without much consideration, but those with respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD) often require breathing treatments to achieve optimal breathing. It is estimated that breathing disorders like asthma affect nearly 25 million people in the United States alone.^(1,2)

Breathing treatments involve the delivery of medications to the lungs, typically through a prescription-based inhaler or nebulizer. Each of these methods has its own advantages and potential risks.

An inhaler is a handheld device that contains medication in a pressurized canister. It releases the medication in aerosol form directly into the mouth. Alternatively, nasal inhalers can release medication into the nose.

On the other hand, a nebulizer utilizes an air compressor to convert medication into a fine mist that is inhaled through a face mask. Some nebulizers require an electrical outlet, while others are portable and operate on batteries.

While both inhalers and nebulizers can effectively treat many respiratory conditions, certain individuals may experience better outcomes with one method over the other. Let us look at the different types of breathing treatments.

1. Bronchodilators for Breathing

Bronchodilators play a crucial role in helping individuals breathe by relaxing the muscles in the lower airways, specifically the bronchi and bronchioles. These small passageways within the lungs aid in efficient breathing. By dilating these air passages, bronchodilators facilitate the easier flow of oxygen into the lungs. They are commonly used to treat respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Additionally, doctors may prescribe bronchodilators for other conditions, including breathing difficulties associated with lung cancer or exercise-induced constriction.

A wide range of bronchodilators are available, with the majority belonging to the category of beta2-agonists. These medications stimulate the body’s beta cells to relax the airways.

The most frequently used bronchodilators include:

• Short-acting beta agonists (SABA): These medications provide rapid relief for severe symptoms like those experienced during an asthma attack. They are typically administered through inhalers and may include drugs such as albuterol and levalbuterol.^(3,4)
• Long-acting beta agonists (LABA): These drugs are taken regularly to maintain relaxed bronchial tubes. They include medications like formoterol and salmeterol. It’s important to note that individuals with asthma who use LABAs must also use corticosteroids as part of their treatment.⁽⁵⁾

Bronchodilators have proved to be valuable in managing respiratory conditions by promoting airway relaxation and ensuring improved breathing.

2. Corticosteroids for Breathing

Corticosteroids are synthetic hormones that mimic the body’s natural hormones, serving to reduce inflammation associated with allergies and conditions like asthma. While corticosteroids are commonly prescribed for asthma, their effectiveness for chronic obstructive pulmonary disease (COPD) has varying levels of evidence. A 2012 study suggests that corticosteroids alone may not be effective as the sole treatment for COPD.⁽⁶⁾ However, a 2014 article acknowledged that several placebo-controlled trials have demonstrated the potential of corticosteroids in managing moderate to severe COPD, but their efficacy in treating stable COPD remains inconclusive.⁽⁷⁾

Corticosteroids are available in oral, inhaled, and intravenous (IV) formulations. Some specific corticosteroids that doctors may prescribe as breathing treatments include budesonide, mometasone, and fluticasone.

In many cases, doctors combine corticosteroids with long-acting beta2-agonists, a treatment approach known as combination therapy. This combined approach aims to provide comprehensive relief and control of respiratory symptoms.

3. Mucolytics for Breathing

Mucolytics are medications designed to aid in the loosening of sputum, which is the mucus produced by the respiratory tract. Excessive mucus can obstruct the airway, leading to symptoms such as persistent coughing, inflammation, and breathing difficulties. Conditions like chronic bronchitis, COPD, and allergic reactions can stimulate the overproduction of mucus in the body.

A comprehensive review conducted by Cochrane in 2019, which analyzed 38 studies, revealed that mucolytics can reduce the risk of exacerbations in individuals with chronic bronchitis and COPD. Furthermore, the use of mucolytics also demonstrated a minor reduction in the number of days where individuals were unable to carry out their daily activities, albeit by less than half a day per month.⁽⁸⁾

4. Epinephrine for Breathing

Individuals with severe allergies are susceptible to a potentially life-threatening reaction known as anaphylaxis. This condition swiftly narrows or obstructs the airways, resulting in breathing difficulties. Without immediate intervention, anaphylaxis can have fatal consequences. Fortunately, for most individuals, administering an epinephrine injection promptly can swiftly reverse the allergic reaction and restore normal breathing.⁽⁹⁾

Individuals with a history of severe allergic reactions or allergies known to trigger anaphylaxis may be required to carry an epinephrine autoinjector, commonly known as an EpiPen, at all times. This portable device enables quick self-administration or administration by a companion, delivering an immediate dose of epinephrine.

5. Antimicrobial Drugs for Breathing

Antimicrobial drugs encompass antibiotics and antifungal medications that combat pathogens responsible for airway infections. Respiratory infections, including common colds, can affect anyone and cause breathing difficulties. However, individuals with chronic respiratory infections are at a higher risk of experiencing severe complications.

For instance, individuals with HIV are susceptible to a specific type of fungal pneumonia known as Pneumocystis pneumonia. To address this infection and alleviate respiratory symptoms, doctors may prescribe a medication called pentamidine, which effectively eliminates the fungus.⁽¹⁰⁾

Typically, oral antimicrobial drugs are prescribed by doctors, although severe infections may necessitate intravenous (IV) treatment. Individuals with significant respiratory disorders might also require inhaled antibiotics as part of their treatment regimen.

6. Immunotherapy for Breathing

Immunotherapy is an innovative approach for treating respiratory issues that is gaining prominence. One form of immunotherapy involves the use of monoclonal antibodies to target and bind to inflammatory chemicals that contribute to breathing difficulties. Monoclonal antibodies have a broad application and can be used to treat various conditions, including certain types of cancer.

In the field of respiratory health, specific monoclonal antibody treatments have shown potential in managing severe asthma that does not respond to traditional treatments. These therapies offer an alternative option for individuals who have not achieved adequate relief from conventional asthma treatments.

Immunotherapy, particularly the use of monoclonal antibodies, represents an exciting frontier in the treatment of respiratory problems, offering novel approaches to alleviate symptoms and improve overall respiratory health.⁽¹¹⁾

Both chronic and acute breathing issues can be distressing, but prompt and appropriate breathing treatments can provide relief and restore normal breathing. For individuals with chronic respiratory conditions like asthma and COPD, regular consultations with a healthcare professional are essential to discuss symptoms and optimize treatment plans.

It is important, therefore, to understand that the best breathing treatment depends on the specific respiratory condition and individual needs. There is no one-size-fits-all answer as treatment effectiveness varies for each person.  It is important to consult with a healthcare professional who can evaluate your specific condition and recommend the most appropriate breathing treatment for you. They will consider factors like the severity of your symptoms, underlying causes, and your overall health to determine the best course of treatment.

By working closely with a respiratory specialist, patients can develop a personalized treatment plan that addresses both chronic and acute respiratory symptoms. This collaborative approach can significantly improve the management of breathing difficulties, making them feel more manageable and enhancing overall respiratory health.

References: