From the Guidelines
Bronchodilator inhalers, specifically long-acting muscarinic antagonists (LAMAs) and long-acting β-agonists (LABAs), are the primary treatment for chronic bronchitis and asbestosis, as they improve lung function, dyspnea, and health status, and reduce exacerbation rates. For chronic bronchitis, the use of short-acting β-agonists and anticholinergic bronchodilators, such as ipratropium bromide, can help control bronchospasm and relieve dyspnea 1. In addition, theophylline may be considered to control chronic cough, but careful monitoring for complications is necessary 1.
Treatment Options
- Long-acting bronchodilators, such as tiotropium (Spiriva) or salmeterol (Serevent), may be used for ongoing symptom management in chronic bronchitis.
- Combination inhalers containing both a LAMA and a LABA, such as tiotropium and salmeterol, can provide more comprehensive symptom control and reduce exacerbations 1.
- Inhaled corticosteroids, such as fluticasone (Flovent) or budesonide (Pulmicort), may be used to reduce airway inflammation in both chronic bronchitis and asbestosis.
Key Considerations
- Proper inhaler technique is essential for effective medication delivery, and patients should request demonstration from their healthcare provider.
- The use of LAMAs, such as tiotropium, has been shown to have a greater effect on exacerbation reduction compared to LABAs, and can also decrease hospitalizations 1.
- Combination treatment with a LABA and a LAMA can increase lung function and reduce symptoms compared to monotherapy, and can also reduce exacerbations compared to monotherapy or inhaled corticosteroid/LABA combination therapy 1.
From the FDA Drug Label
The short-term safety data are based on exposure to fluticasone propionate and salmeterol inhalation powder 250 mcg/50 mcg twice daily in one 6-month and two 1-year clinical trials In the 6-month trial, a total of 723 adult subjects (266 females and 457 males) were treated twice daily with fluticasone propionate and salmeterol inhalation powder 250 mcg/50 mcg, fluticasone propionate inhalation powder 250 mcg, salmeterol inhalation powder, or placebo. The types of adverse reactions and events reported in Trial 3, a 28-week non-U. S. clinical trial in 503 subjects previously treated with ICS who were treated twice daily with fluticasone propionate and salmeterol inhalation powder 500 mcg/50 mcg, The incidence of adverse reactions in the 6-month trial is shown in Table 3.
The type of inhaler used to treat chronic bronchitis is a fluticasone propionate and salmeterol inhalation powder. There is no information in the provided drug label that directly supports the use of a specific type of inhaler for the treatment of asbestosis 2.
From the Research
Types of Inhalers Used to Treat Chronic Bronchitis and Asbestosis
- The primary treatment for chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis, involves the use of inhaled bronchodilators, such as beta2-adrenoceptor agonists and muscarinic receptor antagonists 3.
- Inhaled corticosteroids (ICS) are also commonly used in combination with bronchodilators for the treatment of COPD, particularly in patients with a history of asthma or frequent exacerbations 4.
- Combination inhalers that include a long-acting beta2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) are often used to treat COPD, and the addition of an ICS to these combination inhalers may provide additional benefits in reducing exacerbations and improving quality of life 5.
- The use of triple therapy, which includes an ICS, a LABA, and a LAMA, may be associated with a higher risk of pneumonia, but may also reduce the risk of all-cause mortality compared to combination LABA/LAMA inhalers 5.
Specific Inhaler Options
- Examples of LABAs include indacaterol, olodaterol, and vilanterol 3.
- Examples of LAMAs include glycopyrronium bromide, aclidinium bromide, and umeclidinium bromide 3.
- Combination inhalers that include an ICS, a LABA, and a LAMA are available, and may be used to simplify treatment regimens and improve adherence 5.