Bronchitis: When To Take It Seriously
Louis Fox, PharmD Candidate, and Jeff Prescott, PharmD, RPh
Pharmacists can debunk the myths and provide the facts about treatment for bronchitis
Bronchitis is a condition that develops due to the swelling (from irritation or infection) of your lungs’ airways, known as bronchi. This swelling makes breathing very difficult due to the narrowing and irritation of the airways. Mucus buildup and coughing are also common with bronchitis.
Although the symptoms may be similar, there are 2 very distinct forms of bronchitis: acute and chronic. Each one has different causes and treatments.
Acute bronchitis (sometimes called a “chest cold”) is temporary and is usually caused by a virus. Acute bronchitis is not common with bacterial infections.
The classic symptom of acute bronchitis is a persistent, nagging cough that could last for several weeks. It is also common for thick mucus to be coughed up that may be discolored (normally mucus is clear). Other symptoms to watch out for are fever, tiredness, runny nose, chest congestion, chills, wheezing sounds when breathing, shortness of breath, and sore throat.
This illness is usually selftreatable and self-limited, which means it will run its course over time. Treatment involves relieving your symptoms. Because this illness is usually caused by a virus, antibiotics are not useful, because they only treat infections caused by bacteria.
Over-the-counter medications can be used to treat your symptoms. Acetaminophen lowers fever. You can use cough suppressants (eg, dextromethorphan) if you have a dry, hacking cough that does not produce any mucus, especially if your cough interferes with your sleep. Expectorants (eg, guaifenesin) can help you cough up mucus in your airways. Drinking plenty of water also helps by thinning mucus, making it easier to clear. Contact your doctor if you experience any of these symptoms, so that other illnesses, such as asthma or pneumonia, can be ruled out:
- You have a fever (>100.4°F) that does not decrease within 1 week
- You have chest pain with significant shortness of breath
- Your coughing and wheezing continues longer than 1 month
- You cough up blood
- You experience significant weakness that does not improve
Chronic bronchitis is defined as a nagging cough that is present for 3 months out of the year for 2 consecutive years. It is part of a more serious breathing disorder called chronic obstructive pulmonary disease. Chronic bronchitis is a constant irritation of the airways that has caused permanent damage to the lungs over time.
Smoking is the most common cause of chronic bronchitis because of the permanent damage it can do to your lungs. Other causes include repeated infections or exposure to pollutants.
Chronic bronchitis is not reversible. The goal of treatment is to improve quality of life and prevent complications. Therapy is targeted at opening your airways and reducing swelling to make breathing easier and slow down the progression of the disease.
Inhaled bronchodilators and corticosteroids are the types of drugs most often used to manage chronic bronchitis. Bronchodilators open up your airways to allow more air to pass through. Corticosteroids reduce airway swelling. These medications require a prescription and need to be monitored so you are receive the best dose with the fewest side effects.
In severe cases, treatment with additional oxygen or even surgery may be required. At worst, a complete lung transplant may be necessary.
Both acute and chronic bronchitis must be taken seriously. If you have any questions or concerns, contact your doctor or pharmacist for more information.
Mr. Fox is a PharmD candidate at Raabe College of Pharmacy, Ohio Northern University. Dr. Prescott is senior vice president of clinical and scientific affairs for Pharmacy Times.