With increasing doses, a large number of side effects occur, especially in elderly patients:Therefore, when using methylxanthines (short and prolonged action), it is recommended to determine the level of theophylline in the blood at the beginning of the treatment of chronic obstructive bronchitis, every 6-12 months and after changing doses and preparations.The most rational sequence of bronchodilators in COPD patients is as follows:Sequence and volume of bronchodilator treatment of chronic obstructive bronchitis.Improvement of bronchial drainage is the most important task of treating chronic obstructive bronchitis. The usual dose is 1-2 doses of aerosol 3 times a day. Report these symptoms promptly, even if you don't feel sick. Examples:Need more pillows or have to sit up to sleep because of breathing difficulty,More tired because you're working harder to breathe,Need breathing treatments or inhalers more often than usual,Wake up short of breath more than once a night,Changes in thickness or amount (more than you usually have or more than you are able to cough out),Swelling in your ankles, feet, or legs that is new or has become worse and doesn't go away after a night's sleep with your feet up,Unexplained weight loss or gain of 2 pounds in a day or 5 pounds in a week,Fever, especially with cold or flu symptoms,Restlessness, confusion, forgetfulness, slurring of speech, or irritability,Unexplained, extreme fatigue or weakness that lasts for more than a day.Centers for Disease Control and Prevention.Global Initiative for Chronic Obstructive Lung Disease. Thyme, the most effective herb for fighting bronchopulmonary diseases. The prolonged effect of these drugs (up to 12 hours after inhalation or oral administration) is due to their accumulation in the lungs.In contrast to the short-acting beta2-agonists, the effect is slow in the listed long-acting drugs, therefore they are used mainly for long-term permanent (or course) bronchodilator therapy to prevent the progression of bronchial obstruction and exacerbations of the disease. Theophylline also blocks the purine receptors of the bronchi, eliminating the bronchoconstrictive effect of adenosine.In addition, theophylline inhibits the degranulation of mast cells and the isolation of inflammatory mediators from them. These include: theodore, theotard, theopek, durofillin, ventax, theogard, teobid, slobid, euphyllin SR, and others.Preparations of the second generation last about 24 hours; they are prescribed once a day. can be added to the treatment of chronic obstructive bronchitis.
Coughing can be severe enough at times to injure the chest wall, break ribs, or even cause a person to pass out (faint).During exacerbations (periods where the condition is worsens) of chronic bronchitis, wheezing may occur because of the muscular tightness and inflammation of the airways. Although you can’t reverse the lung damage, medication and lifestyle changes can help you manage the symptoms. The drug is prescribed 1 tablet (8 mg) 3 times a day. Expanded indications for the appointment of corticosteroids, it becomes preferable to their systemic appointment (oral or intravenous) in short courses.

With intravenous drip, a longer duration of action (6-8 hours) can be achieved.The theophyllines of prolonged action in recent years are widely used for the treatment of chronic obstructive bronchitis and bronchial asthma. Strengthens the penetration of antibiotics into the bronchial secretion and bronchial mucosa, increasing the effectiveness of antibiotic therapy and shortening its duration.Carbocysteine normalizes the quantitative ratio of acidic and neutral sialomucines to bronchial secretions, reducing the viscosity of sputum. These may be used as inhaled corticosteroids such as fluticasone (Flovent) and.Though antibiotics play a limited role in treating chronic bronchitis, they become necessary in some situations.If the doctor suspects a bacterial infection, antibiotics may be prescribed.People with underlying chronic lung problems may also need to be treated with antibiotics.In severe cases of chronic bronchitis, home oxygen may be necessary.In rare cases, the patient may be hospitalized if they experience breathing difficulty that doesn't respond to treatment. The beginning of the drug - after 30 seconds, the maximum effect - after 2 hours, the duration of the action does not exceed 6 hours.Combinent is the second combined aerosol preparation containing 20 μg. Drugs of this group are administered by inhalation and are considered a means of choice mainly for relief of attacks of acute bronchial obstruction (for example, in patients with bronchial asthma) and treatment chronic obstructive bronchitis.Their action begins 5-10 minutes after inhalation (in some cases before), the maximum effect is manifested in 20-40 minutes, the duration of the action is 4-6 hours.The most common drug of this group is salbutamol (ventolin), which is considered one of the safest beta-adrenomimetics. Increases the synthesis of glutathione, which takes part in detoxification processes.Ambroxol (lazolvan) stimulates the formation of a tracheobronchial secretion of reduced viscosity due to the depolymerization of acid mucopolysaccharides of bronchial mucus and the production of neutral mucopolysaccharides by goblet cells. In other cases, even the period of exacerbation of the disease and exacerbation of bronchial obstructive syndrome, the use of antibiotics in patients with chronic bronchitis has not been proven.It has already been mentioned above that the most common exacerbations of chronic bronchitis are caused by Streptococcus pneumonia, Haemophilus influenzae, Moraxella catanalis, or the association of Pseudomonas aeruginosa with morocell (in smokers). The irritating effect that nicotine exerts on the lung tissue will nullify all attempts to "unblock" the work of the bronchi, improve blood circulation in the respiratory organs and their tissues, remove the coughing spells and bring the breath into a normal state.Modern medicine suggests combining two treatment options - basic and symptomatic.

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