Asthma: Over The Counter Treatment (cont.)
How do over-the-counter (OTC) medicines for asthma work?
Epinephrine acts by relaxing the muscles of the airways, thereby opening up
the airways and allowing air to flow in and out of the lungs more easily.
Ephedrine also relaxes the muscles of the airways.
What factors should be considered in choosing and using OTC epinephrine or ephedrine?
Despite the development of newer medications, epinephrine and ephedrine
remain available as OTC medications. The choice of epinephrine or ephedrine
should involve consideration of several factors. Most importantly, the asthma
should be mild and less frequent, defined as occurring less than once per week
and lasting from a few hours to a few days at most. OTC epinephrine or
ephedrine is best used under the guidance of a physician. A patient should seek
medical attention and prepare to switch to a prescription asthma medication if
(1) moderate to severe asthma develops, (2) frequent or regular doses of
epinephrine or ephedrine are needed to relieve symptoms, (3) episodes of asthma
occur once or more per week, or (4) asthmatic episodes develop at
night.
OTC epinephrine is available in various concentrations for oral inhalation
or as a solution in vaporized form (nebulization). Both forms may or may not
contain alcohol or sulfite as preservatives. For example, AsthmaHaler Mist does
not contain alcohol. Alcohol and sulfite preservatives may trigger an attack of
asthma, and therefore, patients whose asthma is sensitive to these
preservatives should read product labels carefully. The nebulized epinephrine
solutions may or may not require diluting with a separate saline (salt)
solution before use. Several saline solutions are available OTC in various
concentrations. Again, careful reading of the label will provide information
about combining an epinephrine solution for nebulization with a specific saline
solution. Oral epinephrine is unavailable because it is rapidly broken down in
the digestive system before it can reach the lungs. Once inhaled, epinephrine
should provide rapid relief of symptoms (within five to 10 minutes) and continue
working for one to three hours. Good inhaler and nebulizing techniques are critical in
the use of epinephrine. If epinephrine is used frequently, tolerance to its
effects occurs; that is, repeated inhalations provide progressively less and
less benefit. Some of these inhalers use a chlorofluorcarbon (CFC) propellant. These gases have been shown to damage the ozone layer. The FDA is likely to expand the ban on CFC propellants making these agents unavailable in the near future.
OTC ephedrine is available only as an oral medication in combination with
guaifenesin as caplets, tablets, or syrup. (Guaifenesin is an expectorant that
loosens mucus in the airways and facilitates its removal by coughing.) Caution
should be used when first starting these products since they occasionally
irritate the airways of some patients and may make the asthma worse. OTC
ephedrine should provide relief of symptoms within 15-60 minutes and may
continue to be effective for three to five hours. Continued use of ephedrine, like
frequent use of epinephrine, leads to tolerance.
Neither epinephrine or ephedrine should be continued if thick mucus or
sputum (colored mucus) develops and/or a persistent or chronic cough occurs
with the asthma. These may be signs of infection in the lungs and require
immediate medical attention. If OTC asthma drugs do not relieve an episode of
asthma within 10 (for epinephrine) or 60 minutes (for ephedrine) or the
symptoms worsen, medical attention should be sought immediately.
Next: What side effects and drug interactions
are there with OTC asthma medicines? »
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From the Doctors at MedicineNet.com  |
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- Nebulizer for Asthma - Learn how to use a portable asthma home nebulizer (breathing machine), assemble the mask (mouthpiece) and measure the medication for nebulization treatment. Source:WebMD Medical Reference from The Cleveland Clinic
- Asthma - Get the facts on asthma symptoms, signs, diagnosis, causes and triggers of asthma attacks, treatment information, medication, inhalers, and management. Asthma in children and exercise-induced asthma are types of asthma. Source:MedicineNet
- Allergy - Get the facts about allergic reactions, causes, allergy types (food, dust, mold, seasonal), symptoms and signs (skin rash, itching, red bumps, sneezing). Source:MedicineNet
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