From the Guidelines
Reactive airway disease after a cold can be effectively managed with a short-acting bronchodilator like albuterol and an inhaled corticosteroid like fluticasone, along with symptomatic relief measures and avoidance of irritants. The management of reactive airway disease after a cold focuses on relieving symptoms and reducing airway inflammation. According to the most recent and highest quality study 1, the approach to managing acute respiratory tract infections, including those that may lead to reactive airway disease, emphasizes the importance of distinguishing between viral and bacterial causes to avoid unnecessary antibiotic use.
Key Management Strategies:
- Use of a short-acting bronchodilator like albuterol (2 puffs every 4-6 hours as needed) to relieve immediate symptoms of wheezing, coughing, and shortness of breath.
- Consider adding an inhaled corticosteroid like fluticasone (2 puffs twice daily) for 1-2 weeks to reduce airway inflammation for persistent symptoms.
- Stay hydrated and use a humidifier to moisten the air.
- Avoid irritants like smoke, strong perfumes, and cold air which can worsen symptoms.
- Over-the-counter antihistamines may help if allergies are contributing to symptoms.
When to Seek Medical Attention:
If symptoms persist beyond 2-3 weeks, worsen significantly, or include high fever, severe shortness of breath, or chest pain, it is crucial to seek medical attention promptly. Reactive airways occur because viral infections can damage the airway lining and trigger inflammation, causing the smooth muscles around airways to become hypersensitive and constrict more easily in response to irritants. Most post-viral reactive airway symptoms resolve within a few weeks with appropriate management, as suggested by guidelines for managing respiratory infections 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Reactive Airway After a Cold
- A reactive airway after a cold can be a symptom of an underlying respiratory condition such as asthma or chronic obstructive pulmonary disease (COPD) 2.
- Inhaled corticosteroids (ICS) are commonly used to treat asthma and COPD, and can help to reduce inflammation and improve lung function 2, 3, 4.
- Long-acting beta-agonists (LABAs) can also be used in combination with ICS to improve lung function and reduce symptoms 2, 3, 4.
- Studies have shown that combination therapy with ICS and LABA can be more effective than monotherapy with either ICS or LABA alone 3, 4.
- The effects of ICS/LABA combination therapy on the airway microbiome are not fully understood, but one study found that fluticasone-based ICS/LABA therapy can modify the airway microbiome in patients with COPD 5.
- Another study found that once-daily inhaled steroid (fluticasone furoate) combined with long-acting beta-2 agonist (vilanterol) and long-acting muscarinic antagonist (umeclidinium) can improve lung function tests in asthma patients 6.
Treatment Options
- Inhaled corticosteroids (ICS) such as fluticasone propionate and budesonide can be used to treat asthma and COPD 2, 4.
- Long-acting beta-agonists (LABAs) such as formoterol and salmeterol can be used in combination with ICS to improve lung function and reduce symptoms 2, 3, 4.
- Combination therapy with ICS and LABA can be more effective than monotherapy with either ICS or LABA alone 3, 4.
- Other treatment options, such as long-acting muscarinic antagonists (LAMAs) and phosphodiesterase-4 inhibitors, may also be used to treat asthma and COPD 6.
Lung Function Tests
- Lung function tests, such as forced expiratory volume in 1 second (FEV1) and peak flow, can be used to assess the effectiveness of treatment in patients with asthma and COPD 6.
- Impulse oscillometry (IOS) can also be used to assess small-airway dysfunction in patients with asthma 3.
- The effects of ICS/LABA combination therapy on lung function tests can vary depending on the specific medication and dosage used 3, 4, 6.