Care During Chemotherapy and Beyond
What is bronchitis?
- Bronchitis is a condition where there is swelling and irritation in your air passages
(called the bronchi). You may have:
- Acute Bronchitis: When the bronchitis is at its' worst, and is
happening now or
- Chronic Bronchitis: When the bronchitis has been occurring for
a long time.
- People with acute bronchitis usually have a cough with sputum (secretions or phlegm),
and sometimes have pain when they take a deep breath.
- You may develop acute bronchitis from:
- Smoking cigarettes
- Environmental irritants, such as pollution, chemicals and hair spray
- If you are elderly, or have an altered immune system from chemotherapy, long-term
steroid use, or have chronic diseases
- Acute bronchitis may be from bacteria, but is more commonly due to a virus. Even
though you may have greenish-or yellowish sputum, bronchitis is usually an inflammation
of your air passages, and there may be no bacteria present.
- You may be treated with antibiotics if there are bacteria present in a sputum sample,
or if your healthcare provider is concerned that bacteria has caused an infection.
- If your bronchitis is due to a virus, your symptoms may take 2 or more weeks to
resolve, but antibiotics won't help. Treatment of a virus includes cough medications,
drinking lots of fluids, and avoiding irritants.
- Chronic bronchitis may have been caused by long-term exposure to smoking cigarettes,
air pollution, or other irritants. People with chronic bronchitis have trouble breathing
because thick mucus may clog their air passages. They will also have inflammation
in their air passages, with similar symptoms.
- Chronic bronchitis is diagnosed based on symptoms of a productive cough, on most
mornings, for 3 or more months, for 2 years in a row.
- Because this is a long-term disease, those with chronic bronchitis may go through
periods when they feel well, and then go through periods when they feel ill.
- Severe outbreaks of cough, shortness of breath and congestion (called exacerbations),
may last for 3 months at a time, and occur a few times a year. As the disease progresses,
the periods when you will be less short of breath will lessen.
What are some symptoms to look for?
- You may notice that you are wheezing, or have shortness of breath with both types
- You may have fever, chills, or a headache if you have an acute bronchitis.
- You may have pain in your muscles, or pain in your lungs when you take a deep breath
with both types of bronchitis, especially if you are coughing really hard, for long
periods of time.
- You may be overly tired, or very weak (fatigued). It may be hard for you to do any
kind of your normal activities with both types of bronchitis.
- You may have sudden onset of coughing spells, or a long-term (chronic) cough.
You may or may not be able to bring up any secretions (sputum), or you may bring
up greenish-yellow sputum. People with chronic bronchitis tend to bring up a lot
of sputum early on in the morning.
- You may experience shortness of breath, either at rest or while performing any type
of activity. This may include walking to the door, or climbing stairs.
- You may have trouble lying flat in bed, and you may have to sleep on 2 or more pillows.
Your shortness of breath may cause you to wake up in the middle of the night.
Things you can do:
- Make sure you tell your doctor, as well as all healthcare providers, about any other
medications you are taking (including over-the-counter, vitamins, or herbal remedies).
- Remind your doctor or healthcare provider if you have a history of diabetes, liver,
kidney, or heart disease. If you have a family history of heart disease, stroke,
high blood cholesterol, or high blood pressure, in a first or second-degree relative,
you may be at risk for certain problems. Notify your healthcare provider if you
have any of these diseases in your family.
- If you are still smoking, you should quit. If you do not smoke, avoid smoke-filled
rooms. Smoking first or second-hand can further damage lung tissue. Discuss with
your healthcare provider techniques that can help you quit.
- Avoid people who are sick. Wash your hands often, with soap and water, for at least
15 seconds at a time. Use tissues when you sneeze or cough.
- Do not share eating or drinking utensils with anyone.
- If you are over the age of 65 years, or have an altered immune system due to chemotherapy,
chronic disease or steroid use, the Centers for Disease Control (CDC) recommends
that you receive a flu vaccine every year, and a pneumonia vaccine every 5 years.
Discuss this with your healthcare provider if this is right for you.
- People with lung problems need to circulate air from the bottom of their lungs and
out of your lungs (oxygenation), to prevent infection and pneumonia. Using an incentive
spirometer for 15 minutes a day, twice a day, can help promote oxygenation.
- Controlling secretions through coughing and deep breathing will help you to breathe
easier. Remember, if you are dehydrated, your secretions will be thicker, and harder
to bring up. Make sure to drink 2 to 3 liters of fluids (non-alcoholic, non-caffeinated)
per day, to remain well hydrated.
- Taking warm showers or baths, and using a vaporizer, may help to thin out your secretions.
- Try to exercise, as tolerated, to promote air exchange (oxygenation), and to maintain
your optimal level of functioning. Walking, swimming, or light aerobic activity
may also help you to lose weight, and feel better. Make sure to exercise, under
the supervision of your healthcare provider, and discuss with your healthcare provider
how you can create a specific exercise program to suit your needs.
- Try to avoid "environmental allergens" (such as smoke, pollution, and common causes
of seasonal allergies), as well as things that may cause allergies in your home
(hair sprays, mold, dust mites, and pets). These may trigger an episode of shortness
of breath, and make your symptoms worse.
- Keep a diary of your any abnormal symptoms, such as excessive fatigue, shortness
of breath or chest pain, if these are occurring regularly. Write down the foods
that you have eaten, the exercise or activity you were undergoing when the symptoms
occurred, and how you felt before they occurred. This diary may be valuable in identifying
certain "triggers" of your symptoms.
- Questions to ask yourself, may include:
- Did my symptoms occur gradually, or did this episode come on all of a sudden? Was
I feeling anxious? Did I perform any kind of activity, or was I resting?
- Did I eat any different kinds of foods? Was I around any pets? Did I travel recently?
Did I do anything differently than I normally do?
- With severe breathing problems, sleeping at night with your head of the bed elevated
may make it easier to breathe. You may do this by sleeping on 2 or 3 extra pillows.
This will help lung expansion (spreading out), as well as promote the drainage of
- Use relaxation techniques to decrease the amount of anxiety you have. If you feel
anxious, place yourself in a quiet environment, and close your eyes. Take slow,
steady, deep breaths, and try to concentrate on things that have relaxed you in
- You should restrict the amount of alcohol you take in, or avoid it all together.
Alcohol may adversely interact with many medications.
- If you are ordered a medication to treat this disorder, do not stop taking any medication
unless your healthcare provider tells you to. Take the medication exactly as directed.
Do not share your pills with anyone.
- If you miss a dose of your medication, discuss with your healthcare provider what
you should do.
- If you experience symptoms or side effects, especially if severe, be sure to discuss
them with your health care team. They can prescribe medications and/or offer
other suggestions that are effective in managing such problems.
- Keep all your appointments for your treatments.
Drugs that may be prescribed by your doctor:
- Depending on your lung function, and your overall health status, your doctor may
recommend that certain drugs be used to help your lungs function more effectively,
and decrease symptoms. Some of the common drugs that are used to treat lung
problems may include:
- Antibiotics - If your doctor or healthcare provider suspects that
you have a lung infection, he or she may order antibiotic pills or intravenous (IV).
Commonly prescribed antibiotics for lung infections include azithromycin (Zithromax®), and levofloxacin (Levaquin®).
If you are prescribed antibiotics, take the full prescription. Do not stop taking
pills once you feel better
- Anticholinergic agents - these drugs are given to persons with
chronic bronchitis, emphysema, and chronic obstructive lung disease (COLD). Anticholinergic
agents work in a complex manner by relaxing the lung muscles, which will help you
to breathe easier. A commonly prescribed drug is ipatropium bromide (Atrovent®).
- Bronchodilators - These drugs work by opening (or dilating) the
lung passages, and offering relief of symptoms, including shortness of breath. These
drugs, typically given by inhalation (aerosol), but are also available in pill form.
- Beta-adrenergic receptor agonists (Beta-agonists) - Beta-agonists
can be considered bronchodilators, as these drugs relax airway smooth muscle, and
block the release of substances that cause bronchoconstriction, or narrowing of
your lungs, if you are having a lung "spasm." Drugs such as albuterol (Proventil®), or terbutaline (Brethine®),
are commonly used.
- Corticosteroids: Steroids work by decreasing inflammation and swelling,
which may be present with certain lung disorders. People may benefit from steroids,
either inhaled, by pill form, or in the vein (IV).
- Beclomethasone (Beclovent®), an
inhaled steroid, is useful in the treatment of chronic asthma and bronchitis.
Inhaled steroids act directly on the lung tissue, so there are fewer long-term side
effects, compared with a pill or IV form.
- People who have an outbreak of severe shortness of breath and airway inflammation
may be ordered a steroid pill, such as prednisone, for a short period of time. This
is usually given with inhaled steroids.
- Patients with severe asthma or bronchitis may require IV administration of another
steroid, methylprednisolone (Solumedrol®).
- Cough Medications/Decongestants - may help you to be more comfortable
if you are coughing a lot. Guaifenesin is an active ingredient in many cough medications,
may be given alone, but is often combined with other drugs, such as codeine, to
help your cough. Guaifenesin may also be combined with pseudoephedrine (Sudafed®) as a decongestant, or any one of many medications,
depending on your symptoms. Another common medication you may receive is Hydrocodone
Bitartrate-Homatropine Methylbromide (Hycodan®).
This is a narcotic antitussive (anti-cough medication), which will help relieve
- Diuretics - may be known as "water pills" as they work to prevent
or treat lung congestion by making you urinate out extra fluid. Some examples of
this medication may include furosemide (Lasix®),
and Hydrochlorthiazide. You may receive this medication alone or in combination
with other medications.
- Narcotics - Such as Morphine Sulfate may be useful, in certain
cases of shortness of breath, to relieve your body's need to breathe. Morphine is
called an Opiate. Opiates tell your breathing center in your main brain stem not
to breathe so hard. This might make you more comfortable. If you are taking morphine,
though, make sure you discuss with your healthcare provider common side effects,
such as constipation, drowsiness, nausea and vomiting, and how to control these
- Oxygen therapy - If you are experiencing shortness of breath at
rest, or on exertion, your healthcare provider may see if oxygen therapy is right
for you. This will help reduce your work breathing. You may take oxygen when your
symptoms are at their worst. For example, some people are only on oxygen at nighttime,
and not during the day. Some take oxygen when they are performing activities, but
not all the time.
- Your healthcare provider will discuss with you which treatments are helpful to you.
- Do not stop any medications abruptly, as serious side effects may occur
When to call your doctor or health care provider:
- Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection if you
are receiving chemotherapy).
- If you cough up blood
- Shortness of breath, chest pain or discomfort; swelling of your lips or throat should
be evaluated immediately
- Feeling your heart beat rapidly, or experience palpitations
- Any new rashes on your skin
- Any unusual swelling in your feet and legs
- Weight gain of greater than 3 to 5 pounds in 1 week.
- If your symptoms worsen or do not improve in 3 days of therapy
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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