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Acute bronchitis
When no secondary infection is present, acute
bronchitis is treated in the same way as the common cold. Home care
includes drinking plenty of fluids, resting, not smoking, increasing
moisture in the air with a cool mist humidifier, and taking
acetaminophen (Datril, Tylenol, Panadol) for fever and pain. Aspirin
should not be given to children because of its association with the
serious illness, Reye's syndrome.
Cough suppressants are used only when the cough
is dry and produces no sputum. If the patient is coughing up phlegm,
the cough should be allowed to continue. The purpose of the cough it
to bring up extra mucus and irritants from the lungs. When coughing
is suppressed, the mucus accumulates in the plugged airways and can
become a breeding ground for pneumonia bacteria.
Expectorant cough medicines, unlike cough
suppressants, do not stop the cough. Instead they are used to thin
the mucus in the lungs, making it easier to cough up. This type of
cough medicine may be helpful to individuals suffering from
bronchitis. People who are unsure about what type of medications are
in over-the-counter cough syrups should ask their pharmacist for an
explanation.
If a secondary bacterial infection is present,
the infection is treated with an antibiotic. Patients need to take
the entire amount of antibiotic prescribed. Stopping the antibiotic
early can lead to a return of the infection. Tetracycline or
ampicillin are often used to treat adults. Other possibilities
include trimethoprim/sulfamethoxazole (Bactrim or Septra) and the
newer erythromycin-like drugs, such as azithromycin (Zithromax) and
clarithromycin (Biaxin). Children under age eight are usually given
amoxicillin (Amoxil, Pentamox, Sumox, Trimox), because tetracycline
discolors permanent teeth that have not yet come in.
Chronic bronchitis
The treatment of chronic bronchitis is complex
and depends on the stage of chronic bronchitis and whether other
health problems are present. Lifestyle changes, such as quitting
smoking and avoiding secondhand smoke or polluted air, are an
important first step. Controlled exercise performed on a regular
basis is also important.
Drug therapy begins with bronchodilators. These
drugs relax the muscles of the bronchial tubes and allow increased
air flow. They can be taken by mouth or inhaled using a nebulizer. A
nebulizer is a device that delivers a regulated flow of medication
into the airways. Common bronchodilators include albuterol (Ventolin,
Proventil, Apo-Salvent) and metaproterenol (Alupent, Orciprenaline,
Metaprel, Dey-Dose).
Anti-inflammatory medications are added to reduce
swelling of the airway tissue. Corticosteroids, such as prednisone,
can be taken orally or intravenously. Other steroids are inhaled.
Long-term steroid use can have serious side effects. Other drugs,
such as ipratropium (Atrovent), are given to reduce the quantity of
mucus produced.
As the disease progresses, the patient may need
supplemental oxygen. Complications of COPD are many and often
require hospitalization in the latter stages of the disease. |