Drugs for shortness of breath

Dyspnea is an unpleasant symptom that accompanies many diseases and conditions. Patients complain of uncomfortable or constricted breathing, inability to take a full breath in or out, dizziness. Many experience and describe this problem in different ways, which depends on its cause. When selecting treatment, it is important to understand that drugs for shortness of breath can not be the same: they are prescribed by a specialist, focusing on the patient's condition and the underlying disease.

What medications help with shortness of breath?

There is no and cannot be a single drug for dyspnea, because the problem is polyetiologic and can have a lot of different causes, in particular:

• tumor processes;
• lung damage;
• thromboembolism;
• fluid buildup in the pericardial cavity or pleura;
• inflammatory processes (pneumonia, bronchitis);
• bronchial asthma, emphysema;
• chronic heart failure;
• anemia, etc.

Treatment of the above pathologies is fundamentally different, so the drugs used in therapy are not the same.

Medications for shortness of breath are prescribed after determining the cause of the symptom. In mild cases, simple stabilization techniques rather than medications can be used:

• provide fresh air;
• limit physical activity, stop, rest until adequate respiratory recovery;
• perform simple breathing exercises.

After a comprehensive diagnosis, the doctor prescribes drugs for shortness of breath depending on the original underlying disease:

• In bronchial asthma, chronic bronchitis, pulmonary emphysema is shown the use of a special inhaler or nebulizer, which helps to deliver the smallest drops of the drug directly into the respiratory tract.
• In case of increased thrombosis, anticoagulants - blood thinning medications - may be used. Such treatment is used after evaluation of blood tests and consultation with a hematologist.
• In bronchitis and pneumonia, broad-spectrum antibacterial agents are prescribed.
• In edema, fluid accumulation in the pleural or pericardial cavity diuretics, diuretics are indicated.

Among other medications that are often prescribed for shortness of breath, special attention should be paid to bronchodilators (medications that dilate the bronchi) and corticosteroids (hormonal substances). Such medications should never be used as self-medication: they are prescribed only by a doctor on an individual basis.

Opioids are the drugs of choice for dyspnea that cannot be treated with medication. Respiratory depression has not been observed in any clinical trial. The dose needed to treat dyspnea is much lower than the dose needed to treat pain. [1]

It is important to realize that the symptom of dyspnea itself is not treated with medication. It is necessary to restore the patency of the respiratory tract and cardiac activity, normalize the level of oxygen in the blood, stop the development of inflammatory reaction, and in case of intoxication or overdose - to administer antidotes and detoxification therapy.

Benzodiazepines

Benzodiazepines, such as lorazepam and midazolam, have long been used to treat dyspnea in patients with advanced disease and are recommended in many treatment guidelines. However, a systematic literature review and meta-analysis did not find any statistically significant efficacy, only a trend towards symptom relief (LoE 1+). [2] One reason for this may be that the main benefit of these drugs is not so much that they reduce the intensity of dyspnea (which has been a concern in published clinical trials), but that they improve patients' ability to cope. Emotionally.

How do bronchodilators work, and which drugs are the most effective?

The action of bronchodilators is to alleviate asthma, relaxation of the ring muscles, which are in a state of spasm. Thanks to such drugs, there is a rapid release of the respiratory tract and cessation of dyspnea, breathing improves, facilitates the excretion of mucous secretions. [3]

Effective rapid-acting bronchodilators relieve or eliminate asthma symptoms, which is especially important during attacks. There are also prolonged-acting bronchodilators, which are used to prevent the development of attacks and control the clinical picture. [4]

There are known 3 basic categories of such drugs for shortness of breath:

• β-2-antagonists;
• anticholinergies;
• Theophylline.

Fast-acting β-2-antagonists are represented by such agents:

• Alupent;
• Albuterol;
• Maxer;
• Combivent, Duoneb (combination dyspnea drugs that combine both β-2-antagonists and anticholinergics);
• Xopinex.

Fast-acting β-2-antagonists are used in the form of inhalation to eliminate asthmatic attacks of dyspnea. Their activity is manifested within 20 minutes after application and lasts for about five hours. The same inhalers can be used 20 minutes before the expected physical activity to prevent attacks.

Albuterol can also be used in tablets or in the form of an oral solution, although such medications are characterized by a large number of side effects, since they have a systemic effect. Inhaler versions practically do not enter the bloodstream, but accumulate in the lungs, so the side symptoms are less intense.

Prolonged forms of β-2-antagonists are represented by the following medications:

• Foradil;
• Advair (a complex agent combining a β-2-antagonist and an anti-inflammatory component);
• Cirevent.

These medicines are used to control asthmatic dyspnea, not to eliminate attacks. Sirevent and Foradil are used by inhalation, twice a day. Possible side effects include:

• irritability, general weakness;
• an agitated state;
• tachycardia;
• rare - insomnia, digestive disorders.

Atrovent is a typical representative of anticholinergic agents. It is used to control attacks of dyspnea, but not to eliminate attacks. The drug is available as a metered-dose inhaler or inhalation solution. The effectiveness of Atrovent can be increased if it is used in combination with a fast-acting β-2-antagonist. The drug begins to act only 1 h after its administration. Side symptoms are moderate and consist in the appearance of a transient feeling of dryness in the pharynx.

The third type of bronchodilator is Theophylline. It can also be found under the names Unifil, Theo-24, Theo-dur, Slo-bid. This drug is used daily to treat severe cases of shortness of breath that are difficult to control. Among the most likely side effects are: nausea, diarrhea, stomach and head pain, feelings of anxiety, and tachycardia. Important: during treatment with Theophylline it is necessary to stop smoking (including passive smoking), which is associated with the risk of expanding the list of side effects.

What are corticosteroids and how can they help with shortness of breath?

Traditional drugs for shortness of breath in bronchial asthma include inhaled corticosteroid hormones, which have a pronounced anti-inflammatory effect. An exacerbation of the disease is controlled by systemic administration of corticosteroids: the more severe the attacks, the greater the dosage and longer course will be required. [5]

Inhaled corticosteroid medications for shortness of breath are the main medication group used to treat bronchial asthma. These hormonal remedies may include:

• non-halogenated (Budesonide);
• chlorinated (Beclomethasone dipropionate, Asmonex);
• fluorinated (Flunisolide, Fluticasone propionate).

Fluticasone, from practical application, provides optimal control of asthmatic attacks when used at half the dosage of Beclomethasone, with relatively similar side effects.

Unlike systemic-acting corticosteroid drugs for dyspnea, inhaled corticosteroids have a lower risk of side effects, are rapidly inactivated while accumulating in the respiratory tract, and are more bioavailable.

Systemic glucocorticosteroids can be administered intravenously (during attacks of dyspnea), orally (short or long courses), which is especially relevant when inhaled hormonal drugs are ineffective. In this case, the disease is characterized as steroid-dependent. Side effects of such treatment include increased blood pressure, suppression of hypothalamic, pituitary and adrenal function, as well as cataracts, obesity, increased capillary permeability.

Since the application of systemic therapy, prophylactic measures to prevent the development of osteoporosis are simultaneously prescribed.

The most common oral corticosteroids include Prednisone, Prednisolone, Methylprednisolone (Metipred), and Hydrocortisone. Prolonged use of Triamcinolone (Polcortolone) may be accompanied by side effects such as muscular dystrophy, gauntness, weakness. Dexamethasone is not suitable for a prolonged therapeutic course because of the strong suppression of adrenal cortex function, forcing edema. [6]

How do anticholinergics work, and which drugs are best to use?

Anticholinergic (antimuscarinic) drugs for dyspnea relax bronchial smooth muscle, with competitive inhibition of muscarinic receptors. [7], [8]

Ipratropium is a short-acting anticholinergic agent. The dose is 2 to 4 injections (17 mcg per breath) of a metered-dose nebulizer (aerosol) every 5 hours. The effect develops gradually after about half an hour, with maximum activity after 1.5 hours. Combinations of Ipratropium with β-adrenomimetics are possible, including aqueous inhaler device.

Tiotropium belongs to a number of quaternary anticholinergic medications of prolonged activity. For dyspnea use inhalation in medication powder form (18 mcg per dose) and liquid inhaler (2.5 mcg per dose), once a day.

Aclidinium bromide is produced as multi-dose powder inhalers, with a dose of 400 mcg per breath twice daily. Aclidinium is also presented in combination with a β-agonist of prolonged activity in the form of a powder inhaler.

Umeclidinium is used once daily in combination with Vilanterol (prolonged β-agonist) in a powder inhaler. Glycopyrrolate is used twice daily in combination with Indacaterol or Formoterol in a dry or metered-dose inhaler. Revefenacin is used once daily in a nebulizer.

Side effects of anticholinergic medications for dyspnea include pupil dilation with increased risk of development and recurrence of closed-angle glaucoma, oral dryness, and urinary retention.

What are inhalers and how can they be used to treat shortness of breath?

The main advantage of inhalation therapy is the ability to provide a rapid therapeutic effect directly on the respiratory tract using a relatively small volume of drug and low risk of systemic side effects. In the process of inhalation drug solutions are absorbed quickly and effectively, their accumulation in submucosal tissue occurs, and directly in the pathological focus provides a high concentration of the injected drug.

Inhalers can be ultrasonic, compressor, steam, pneumatic, pneumatic, warm-moisture, which is determined by the method of obtaining an aerosol mass. Choosing one or another inhaler, the doctor takes into account the form of the drug used for shortness of breath, and all the parameters of the procedure.

At present, so-called pocket inhalers (liquid or powder) are particularly common. They are used to administer a dosed volume of medication into the respiratory tract. At the same time, such devices can not always be used. The fact is that in practice, the main amount of aerosol settles on the oral mucosa. In addition, as it is used, the pressure in the bottle gradually decreases, so the drug may not be dosed correctly.

Inhalation devices are divided into stationary and portable handheld devices. Given that the treatment of dyspnea often requires multiple treatments throughout the day, portable devices are more popular.

From practice, the most common nebulizers are nebulizers, which are compressor and ultrasonic. In turn, compressor devices can be pneumatic and jet. Compressor inhaler converts the drug solution into a finely dispersed aerosol cloud, which is due to the action of compressed oxygen or compressed air from the compressor. Ultrasonic nebulizers nebulize, thanks to the high-frequency vibrations of piezoelectric crystals. Practical applications show that ultrasonic inhalers are more effective, but require more drug consumption.

Depending on the dispersity, inhalers are low-dispersed (producing particle sizes from 0.05 to 0.1 microns), medium-dispersed (from 0.1 to 1 micron) and coarse-dispersed (more than 1 micron). Medium and low-dispersed inhalers are used for treatment of upper respiratory tract pathologies.

Contraindications to inhaled medications for dyspnea:

• the possibility of coronary spasms;
• post-infarction, post-stroke condition;
• bleeding tendencies, existing bleeding;
• severe cerebral and coronary atherosclerosis;
• spontaneous pneumothorax;
• bullous pulmonary emphysema;
• Oncology.

Basic rules of inhalation administration of drugs for dyspnea:

• Treatments should be started no sooner than 1 hour after a meal or physical activity.
• Do not take expectorants and/or gargle with disinfectants before inhalation. Rinse the mouth with clean water.
• Do not smoke before and after inhalation.

In addition, it should be said about ready-made aerosols, which are used as mucolytic, anti-inflammatory, vasoconstrictor, moisturizing, antimicrobial agents. Antibiotics and antifungal drugs, enzymes, corticosteroids, biostimulants, phytopreparations are administered in the form of aerosols, which allows to significantly enhance the effect of systemic agents and at the same time reduce the risk of side effects.

There are also oil inhalation preparations for shortness of breath. Their purpose is to cover the mucous tissue with a thin protective and softening film. Duration of oil inhalation - no more than 8 minutes.

Drugs for shortness of breath that can be used as part of nebulizer aerosol administration:

Antibacterial agents

Drugs are used to treat inflammatory processes. Inhalations of streptomycin, tetracycline, penicillin, oleandomycin, levomycetin have proven themselves. To date, most often for inhalation procedures use 0.01% miramistin, 1% dioxidine in combination with isotonic sodium chloride solution. Effective in many cases is the antibiotic Fluimucil, which also has mucolytic activity. It is possible to use other antibacterial agents, depending on the pathology and the results of microbiological analysis. The average duration of the course of inhalation is 5-7 days.

Antifungal drugs

In various mycoses against the background of systemic antifungal and anti-inflammatory therapy is often prescribed inhalation of nystatin, sodium salt of levorin, therapeutic course of 12-15 days. It is possible to alternate antifungal solutions with proteolytic enzymes, moisturizing saline, mineral waters.

Glucocorticosteroids

Corticosteroid drugs for shortness of breath are used quite often, because they have a pronounced anti-inflammatory and anti-edema effect. Corticosteroid inhalation is indicated in inflammatory pathologies of the respiratory system, which are accompanied by mucosal edema, bronchospasm, obstruction. A mixture of hydrocortisone hemisuccinate 25 mg, or prednisolone 15 mg, or dexamethasone 2 mg with 3 ml of isotonic sodium chloride solution is used. Inhalations are repeated twice a day, and in case of severe mucosal edema - up to 4 times a day. The duration of the therapeutic course is determined by the doctor, but most often it is up to 10 days. Possible side effect: dryness of the laryngeal mucosa. To minimize the side effect, corticosteroid inhalation alternates with the use of isotonic sodium chloride solution or mineral water.

Proteolytic enzymes

Aerosol administration of proteolytic enzymes is characterized by mucolytic action, optimizes mucociliary clearance, has a local anti-edema and anti-inflammatory effect. Dyspnea preparations with proteolytic enzymes are diluted with isotonic sodium chloride solution or distilled water (Chymotrypsin 3mg + 1ml, Trypsin 3mg + 1ml, Chymotrypsin 5mg + 1ml). Lysozyme is administered as a 0.5% solution, using 3-5 ml of solution per inhalation administration. The procedures are carried out up to 3 times a day, for a week. Important: proteolytic enzymes can cause the development of an allergic reaction, so they should be used with caution.

Mucolytic, mucoregulatory agents

Mucolytics are prescribed in inflammatory processes of the upper respiratory tract to liquefy sputum, improve mucociliary clearance. For example, acetylcysteine is used as a 20% solution of 2 or 4 ml up to four times a day. Side effect of acetylcysteine is the appearance of reflex cough due to local irritation of the respiratory tract. In combined pulmonary pathological processes, the drug is not used, which is associated with an increased risk of bronchospasm. It is possible to use Lazolvan - a preparation of bromhexine, characterized by expectorant and bronchosecretolytic activity. Lazolvan is used 2-4 ml up to 3 times a day, alone or in equal dilution with isotonic sodium chloride solution. Duration of treatment varies, on average it takes 1 week.

Mineral waters

The most frequent components of mineral waters are sodium, magnesium, calcium, potassium iodide. The latter contributes to increasing the volume of mucous secretion, liquefies it. A similar action is expected from carbonic magnesium and sodium. Salt-alkaline water moisturizes well, relieves irritation of mucous tissue. Hydrogen sulfide water promotes vasodilation, activates the function of the mesenteric epithelium.

Phytopreparations, biostimulants, bioactive substances

Mixtures containing extracts and essential oils of eucalyptus, sage, chamomile, peppermint, pine, elecampane, thyme, and kalanchoe are used. When using complex preparations, it is especially important to take into account the possibility of allergies.

What medications help with bronchial asthma?

Dyspnea in bronchial asthma requires comprehensive treatment of the disease, and this is a long-term process with constant monitoring of dynamics. It is important to carefully follow the instructions of doctors, take medications in accordance with the prescription sheet. Most often, specialists prescribe such inhalation medicines as Symbicort turbuhaler, Bufomix isiheiler, Anora Ellipta. In addition, drugs for shortness of breath in other dosage forms are common:

• tablets (Lucast, Teopec, Neophylline, Milukant, etc.);
• solutions (Spiolto Respimat, Spirivi Respimat);
• capsules (Zafiron, Theotard);
• supersense (Salbutamol, Budesonide Intl);
• aerosol (Berodual H, Beclazone Eco, Airetek, Beclofort Evohaler, etc.);
• nebulas (Flixotide, Lorde hyat hyper).

Medications for shortness of breath in asthma fall into two categories:

Baseline agents that are used for a long time to reduce the inflammatory and allergic process, even outside the period of clinical manifestations. Such means include inhalation with Budesonide, Beclomethasone, corticosteroid aerosols. Inhalation treatment allows you to refuse systemic hormonal therapy, deliver the necessary drug directly into the bronchi, minimize the likelihood of side effects. Such treatment is usually supplemented with antileukotrienes (chewable tablets with montelukast), combined agents with budesonide, formoterol, etc.).

Emergency drugs that are used to relieve the patient's condition at the time of dyspnea attacks, to dilate the bronchial lumen and eliminate spasm. Such drugs include methylxanthines (theophylline), B2-adrenoreceptor agonists (aerosols with salbutamol, fenoterol, etc.). Such drugs for dyspnea manifest their effect in 3-4 minutes after administration, thus eliminating smooth muscle spasm in the bronchi for 5 hours, but have no effect on the obstructive mechanism, accompanied by edema and thickening of the bronchial wall as a result of inflammatory reaction.

Dyspnea medicines that control bronchospasm should not be used more than four times a week. The break between repeated use of the aerosol should be more than four hours.

Means based on montelukast are allowed to prescribe to children from 2 years of age. Therapy of bronchial asthma is supplemented with mucolytic, anti-allergic agents, vitamins, phytopreparations.

What medications help with chronic obstructive pulmonary disease (COPD)?

Chronic obstructive pulmonary disease is not completely curable, but the patient's condition can be improved by smoking cessation and vaccination. The disease is treated directly with medication, oxygen therapy and pulmonary rehabilitation measures.

In general, use inhaled drugs for dyspnea, expanding the lumen of the respiratory tract and reducing edema. The most popular in this regard are inhaled bronchodilators that relax bronchial smooth muscle and increase their flow capacity. When using short-acting bronchodilators, the effect occurs within the first minute and lasts for about 5 hours. They are most often used in attacks of shortness of breath.

If you use prolonged-acting bronchodilators, the effect will come later, but will last longer. Such drugs are prescribed for daily administration, sometimes in combination with inhaled corticosteroids.

Often attacks of dyspnea in chronic obstructive pulmonary disease are provoked by a respiratory infectious disease. In such a situation, antibacterial medications and/or systemic corticosteroids are added to inhalation treatment as additional medications.

What drugs are used in the treatment of pulmonary hypertension?

Pulmonary hypertension requires treatment according to the European Protocol. The following medicines for dyspnea may be used as standard:

• Calcium channel blockers - inhibit the transport of calcium ions inside cardiocytes and vessels, reduce the tone of vascular wall muscles, increase coronary blood flow, reduce hypoxia of the heart muscle. Depending on the selected drug, calcium channel blockers are prescribed 1-3 times a day. Most often the choice falls on Nifedipine, Diltiazem, Amlodipine. Side effects include pain in the head, a feeling of fever, dizziness, a sharp drop in blood pressure, edema of the lower extremities.
• Digoxin - causes increase of heart contractions, decreases heart rate, inhibits excitation. Digoxin is used only in decompensation of right ventricular insufficiency. The most frequent side effects: general weakness, headache, loss of appetite, vomiting, diarrhea.
• Warfarin is a blood thinner that improves blood flow. However, the most common side effect of warfarin is hemorrhage.
• Diuretics - help reduce the volume of circulating blood and lower blood pressure, help "unload" the heart.

The main element involved in the energy supply of the body is oxygen. Oxygen therapy is prescribed to patients with any form of pulmonary hypertension, as it allows to reduce the phenomena of hypoxia and normalize the patency of small circle vessels. The action of oxygen therapy is based on breathing pure oxygen to compensate for the lack of oxygen at the cellular level. Treatment is safe, practically devoid of contraindications, does not cause an allergic response. Oxygen is administered in the form of inhalations: the therapy is long-lasting, sometimes for life.

Drugs for shortness of breath in heart failure

Heart failure is talked about if a person's contractile cardiac activity does not meet the needs of metabolism. The pathological condition develops as a result of acute myocardial infarction, coronary atherosclerosis, heart defects, cardiomyopathy, hypertension, cardiac tamponade, and many pulmonary diseases. The most common symptom of emerging heart failure is shortness of breath, which appears at times of physical activity or in a calm state. Additional symptoms include choking and/or night coughs, general weakness, loss of concentration, and swelling (up to ascites).

Heart failure can be acute and chronic. The chronic course is characterized by several stages of development:

1. Dyspnea bothers only after intense physical activity (such that previously did not lead to respiratory problems).
2. Dyspnea occurs even with moderate exertion, additionally there is a cough, hoarseness.
3. Appears lividity of the nasolabial triangle, sometimes the heart hurts, the rhythm is disturbed.
4. Irreversible pulmonary changes appear.

First of all, the doctor directs therapeutic measures to eliminate or alleviate the underlying pathological process. As for medications, they should restore normal blood flow, eliminate congestion, prevent further progression of the disease. The impact on the underlying cause will help to further get rid of dyspnea.

The most common medications of choice for shortness of breath caused by heart failure are:

• Diuretics (Diacarb, Furosemide, Hypothiazide) - help to remove excess intercellular fluid, eliminate swelling, relieve the circulatory system. It is possible to use third-line drugs - potassium-saving diuretics: Spironolactone, Triamterene, Finerenone, etc.
• Angiotensin-converting enzyme inhibitors (ACEIs: Enalapril, Captopril, Ramipril, Lisinopril, etc.) - improve the heart's ability to eject blood from the ventricles, widen the vascular lumen, improve blood circulation, normalize blood pressure.
• Beta-blockers (Atenolol, Bisoprolol, Metoprolol, Carvedilol, Nebivolol, etc.) - stabilize heart rate, normalize blood pressure, reduce manifestations of myocardial hypoxia.
• Inhibitors of sGlt2 (Empagliflozin, Dapagliflozin, Canagliflozin) - block glucose reabsorption.

Additionally, in dyspnea due to heart failure, it is possible to use nitrates (known Nitroglycerin), or similar medications of prolonged action (Monosan, Cardiket).

To support the myocardium, it is recommended to take multivitamin complexes containing vitamin groups A, B, C, E, F, potassium and magnesium, if possible - means with omega-3 fatty acids.

As a comprehensive approach, cardiometabolic drugs (Ranolazine, Mildronate, Riboxin, Preductal) are connected, and in case of arrhythmia - Amiodarone, Digoxin.

A drug for shortness of breath in bronchitis

In obstructive bronchitis, shortness of breath occurs in most cases. However, its manifestations vary in severity - from a moderate feeling of lack of air during exercise to severe respiratory failure. In addition, there is a cough and a specific "wheezing" breath.

Dyspnea can also occur after a severe coughing fit or physical exertion. The symptom occurs with swelling of the bronchial mucosa, as well as with spasm.

The respiratory tract is conventionally divided into upper and lower: the upper is represented by the nasal cavity and throat, and the lower - the larynx, trachea and bronchi. In patients with obstructive bronchitis, the inflamed mucosal tissue swells. In this case, there is a release of mucus - sputum, and bronchial muscles spasm and seem to be compressed. Due to the pathological process, the bronchial lumen narrows, creating obstacles to the free transport of air through the respiratory system.

Patients with obstructive bronchitis have difficulty breathing, and if the swelling becomes severe, then there are attacks of suffocation, which without the use of the necessary drugs can lead to death.

The use of certain drugs for shortness of breath in bronchitis is shown individually and depends on the cause of the disease. In this case, the first task of the doctor is to facilitate the patient's respiratory function. For this purpose can be prescribed:

• sputum-lowering medications;
• Bronchodilators to relieve edema, eliminate spasm and widen the bronchial lumen.

Bronchitis of bacterial origin requires the use of antibiotic therapy, and allergic inflammatory process - an indication for taking antihistamines and bronchodilators, as well as corticosteroids.

In most cases, the use of nebulizer or inhaler is recommended. For inhalations, solutions of mucolytic agents (Ambroxol, Acetylcysteine), bronchodilators (ipratropium bromide, Fenoterol) are used. Medications are diluted with isotonic sodium chloride solution. Sometimes treatment with inhaled corticosteroids is indicated. The duration of the treatment course and frequency of use of drugs for dyspnea are prescribed individually.

How to get rid of shortness of breath after coronavirus?

According to statistics, more than 20% of people who have had a coronavirus infection, find themselves such a symptom as shortness of breath at the slightest physical exertion. Breathing may become difficult while climbing stairs, walking, and even in an almost calm state.

Postcoronavirus dyspnea can persist for a relatively long time, as can loss of sense of smell. The problem is caused by the body's attempt to fight hypoxia, as well as a drop in saturation. The condition is transient, recovery can take several weeks or months. In some cases, it is necessary to consult specialists, use a concentrator.

How does shortness of breath manifest after coronavirus?

• A feeling of tightness in the chest appears.
• Inhalations and exhalations become more frequent, and sometimes dizziness is bothersome.
• There is difficulty in trying to get more air into the lungs.
• Respiratory movements are predominantly shallow.

The most common causes of postictal dyspnea are:

• Fibrotic changes (replacement of parenchyma - lung spongy tissue - by connective tissue).
• Filling of alveoli with fluid and "switching them off" from the gas exchange process.
• Psychogenic dyspnea.
• Cardiovascular problems.

Since the causes of this disorder can be different, the drugs for dyspnea after coronavirus infection are radically different. First, the doctor performs the necessary diagnostic measures, determines the focus of the problem. Then decides on the most appropriate methods of treatment. This can be oxygen therapy. Inhalations, physiotherapy, breathing exercises, LFK and massage, as well as drug therapy with medications.

The following groups of medicines for shortness of breath may be used:

• bronchodilators;
• sputum thinners;
• expectorants;
• antibiotics and antiviral medications;
• immunomodulators.

Treatment is prescribed on an individual basis. It is often practiced to administer drugs through a nebulizer (inhaler), for which ready-made moisturizing medications based on isotonic sodium chloride solution are used, as well as expectorants. If necessary, bronchodilators and anti-inflammatory drugs that help to eliminate shortness of breath are connected.

How to choose the most appropriate drug for shortness of breath?

It is not possible to choose a suitable drug for shortness of breath on your own: the correct remedy is prescribed by a doctor after identifying the root cause of the unpleasant symptom. If the doctor considers it necessary, he will refer the patient to additional consultations with a pulmonologist, immunologist, cardiologist, neurologist and others.

Obligatory laboratory diagnostics, including general and biochemical blood tests, assessment of the level of certain hormones in the blood, urine examination. As an instrumental diagnosis, it is possible to prescribe spirography (assessment of the volume and speed of respiratory function), chest X-ray, bronchoscopy, magnetic resonance or computed tomography, electrocardiography.

With pathologies of the bronchopulmonary apparatus, it is possible to use the following drugs for dyspnea:

• antibacterial agents (if bacterial pathology is confirmed, prescribe drugs of penicillin, cephalosporin, fluoroquinolone series);
• Mucolytics (if there is viscous, poorly separated sputum, it is indicated to take Mukaltin, Acetylcysteine, Lazolvan, Ambroxol, Pulmolor);
• bronchodilators (patients with asthma or bronchial obstruction are prescribed Salbutamol, Spiriva, Ventolin, etc.);
• Inhaled corticosteroid medications (Pulmicort, Seretide);
• systemic corticosteroid medications (in complex situations, in the development of complications of the underlying disease).

In cardiovascular disease, radically different medications for shortness of breath are indicated:

• beta-blockers (Anapriline, Bisoprolol, Nebilet, etc.);
• diuretics (Furosemide, Lasix);
• drugs that optimize trophicity of the heart muscle (Asparcam, Panangin, ATP-long);
• cardiac glycosides, cardiotonics (Digoxin, Celanide).

Other medications may also be used, depending on the underlying cause of dyspnea.

What precautions should I take when using medications for shortness of breath?

Rule No. 1: drugs for shortness of breath should be prescribed by a doctor, there should be no self-medication. In addition, you can not make your own adjustments to the treatment: change doses, frequency of use, duration of the treatment course.

Today there are many medications, including those used to eliminate shortness of breath in various diseases. These can be tablets, capsules, powders and solutions, including for inhalation administration.

The direction, intensity and duration of action of a particular drug largely depend on the route of administration. Selection and change of the method of administration is carried out by a doctor, after determining the state and dynamics of the pathological process. Each drug when entering the body should initiate an appropriate reaction and manifest its effect exactly where it is necessary. But some factors can adversely affect the effectiveness of drugs, so the use of drugs for shortness of breath has several rules:

• Medications should be taken exactly as prescribed by your doctor, in the correct dose and sequence;
• if necessary, it is better to write down the doctor's prescriptions, paying attention to the frequency of intake, dose, time of intake (before meals, with meals, after meals), possibility of chopping or chewing, etc.;
• It is not advisable to take dyspnea medicines in combination with other medicines unless this has been discussed with your doctor;
• Any questions about taking prescribed medicines should be referred only to your doctor;
• if you accidentally miss the time of administration, you must not take double the dose of the medicine at the next appointment, you must resume taking it according to the schedule;
• if the tablets have a special coating, they must not be divided or chewed;
• capsules should also be swallowed whole without removing the powder.

If there are no other recommendations for taking medications, oral medications for shortness of breath should be washed down with clean water, at least 150-200 ml.

Alcohol and nicotine can alter the effectiveness and action of many medicines and are not compatible with some medicines. You should not drink alcohol during treatment. This can increase side effects and negatively affect the effectiveness of therapy. In many patients, simultaneous intake of alcohol causes a sharp change in blood pressure, heart rhythm disturbance and other troubles.

In order that the drugs for shortness of breath do not harm, but improve the condition, take them only after consultation with a doctor, carefully following all recommendations and instructions.