Inhalers that require prescriptions include albuterol, marketed as Proventil and ProAir, and metaproterenol, marketed as Alupent, according to MedicineNet. These inhaled treatments are in the class of short-acting beta2-agonists. Another class of prescription inhalers is inhaled corticosteroids, marketed as Flovent, Aerobid, Beclovent and Asmanex. Physicians also prescribe anticholinergics in inhaler form, such as ipratropium bromide and tiotropium, marketed as Atrovent and Spiriva. These medications are more effective than ephedrine and epinephrine and produce fewer adverse reactions.
Once patients inhale them, short-acting anticholinergic medications provide relief in approximately 15 minutes, and their effects continue for up to eight hours to treat conditions such as chronic obstructive pulmonary disease, according to the American Thoracic Society. Although beta2-agonists act more quickly, they create more side effects than the anticholinergics, which are effective bronchodilators. Anticholinergics stop the muscles around the bronchi, or the large airways, from becoming tight when lung irritation occurs. Beta-agonists reduce restrictions in the small airways, or bronchioles.
As of 2015, tiotropium is the only long-acting anticholinergic, and it begins working in approximately 20 minutes, explains the American Thoracic Society. Patients inhale the contents of one tiotropium capsule daily and experience relief of airway constriction symptoms for up to 24 hours. Anticholinergic side effects include dry cough and dry mouth. Patients with glaucoma may experience worse vision symptoms, and men with prostate conditions may experience more urination problems.