Medications For Special Situations - Treating Your Condition: Smoking Cessation

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Medications for special situations

Some drugs are reserved for particular patients or circumstances.

Alpha-1-antitrypsin (A1AT) supplements. If you have the genetic flaw that causes A1AT deficiency, you might need supplements of A1AT, the protein that you lack. Selected patients with A1AT deficiency are candidates for this therapy. Studies suggest that patients who receive replacement therapy when they have mild to moderate lung disease have a slower deterioration in lung function.

The supplements, which are derived from human blood, are given as an intravenous infusion weekly, every two weeks, or once a month. With any of these schedules, you get approximately the same total amount of medication over the course of the month. The timetable doesn't seem to affect the drug's effectiveness; how often you get the infusions depends on your preference and your doctor's. The infusions can be given in a doctor's office or in your home by a visiting nurse.

Antibiotics. Antibiotics are prescribed only in specific circumstances. One is when you have a bacterial infection of the respiratory tract. The other is when you have an acute exacerbation of your symptoms that may be a sign of a bacterial infection. In reality, it's difficult to tell what is causing an acute exacerbation — it can be a bacterium or virus, or it can be something other than an infection. But because certain bacteria are often the cause — especially Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis — doctors often prescribe an antibiotic that can treat all of them. A wide variety of antibiotics are commonly used, including both older, cheaper drugs (tetracycline, sulfa, and penicillin derivatives) and newer, more expensive ones (cephalosporins, fluoroquinolones, and macrolide antibiotics).

Theophylline. This drug, which is chemically related to caffeine, can open the airways, and may have additional effects, including improving the action of the diaphragm and reducing inflammation. Theophylline can be taken orally or intravenously. (The intravenous form is called aminophylline.) It is sometimes prescribed if a patient doesn't get enough relief from an anticholinergic medicine, a beta-2 agonist, or both combined.

Theophylline isn't used as often as the other bronchodilators because it carries a higher risk of side effects. Adverse reactions, which are most common with overdose, include nausea, vomiting, headache, insomnia, heart arrhythmias, and convulsions.

Last updated:	May 23, 2007