Berodual: Uses, Side Effects, and Proper Administration for Asthma in Children

Exercise-induced bronchoconstriction

The child is currently eight years old and has asthma, often experiencing persistent coughing.
The doctor prescribed a medication called Berodual.
I would like to ask what type of medication this is, whether it has strong side effects, and if it's true that asthma inhalers can lead to addiction.
Will this medication cause the child to develop a dependency, or will frequent use diminish its effectiveness? Currently, I only administer it when he is coughing excessively; is this approach inappropriate?

Wang, 30~39 year old female. Ask Date: 2002/11/22

Dr. Zhao Chongliang reply Internal Medicine

Hello! Berotec is the English name for a short-acting beta-2 adrenergic agonist used for asthma.
Common side effects of this type of medication include palpitations and tremors, although these are more pronounced with oral formulations.
However, even with tremors, it should not affect a child's ability to do homework.
This class of medication does not cause physiological dependence, but some patients may develop psychological dependence with frequent use.
Therefore, according to the current stepwise management of asthma, this medication is only used in cases of mild intermittent asthma, along with some necessary oral medications, and it should be used "as needed." Since there are only receptors and no nerves in the bronchial tubes, continuous use of such inhaled medications can lead to reduced effectiveness.
If your son is experiencing frequent asthma symptoms, he may have progressed to mild persistent asthma, and it is best to use inhaled corticosteroids combined with a long-acting bronchodilator.
Inhaled corticosteroids act locally and are less likely to affect a child's development.
However, whether it is mild persistent asthma should be evaluated by an asthma specialist.
I would like to introduce a website created by my teacher, Professor Kuo Shou-Hsiung from National Taiwan University, which provides free resources for asthma and chronic obstructive pulmonary disease patients: http://www.chest.org.tw/edu/index.htm.
Sincerely, Dr.
Chao Chong-Liang, Deputy Director of Taipei Hospital, Department of Health.

Reply Date: 2002/11/22

More Info

Berodual is a combination medication commonly used in the management of asthma and chronic obstructive pulmonary disease (COPD). It contains two active ingredients: ipratropium bromide, which is an anticholinergic agent, and fenoterol hydrobromide, a beta-2 adrenergic agonist. This combination works synergistically to relax the muscles in the airways, making it easier for patients to breathe.

Uses of Berodual
In children, Berodual is primarily used for the relief of bronchospasm associated with asthma and other respiratory conditions. It is particularly effective during acute asthma attacks, providing rapid relief from symptoms such as wheezing, coughing, and shortness of breath. The medication can be administered via a nebulizer or metered-dose inhaler, depending on the severity of the symptoms and the child's age.

Side Effects
While Berodual is generally well-tolerated, it can have side effects. Common side effects include:
1. Tremors: Due to the beta-agonist component, some children may experience tremors or shakiness.

2. Increased Heart Rate: Fenoterol can lead to tachycardia (increased heart rate), which may be concerning in some children.

3. Dry Mouth or Throat Irritation: Ipratropium can cause dryness in the mouth or throat.

4. Nervousness or Anxiety: Some children may feel jittery or anxious after using the medication.

Serious side effects are rare but can include allergic reactions, paradoxical bronchospasm (worsening of breathing), and cardiovascular effects. It is essential to monitor your child for any unusual symptoms after administration.

Concerns About Dependency and Efficacy
There is a common misconception that using asthma medications, particularly bronchodilators like Berodual, can lead to addiction or decreased effectiveness over time. However, this is not the case. Berodual does not cause physical dependence, but over-reliance on rescue medications can indicate that the underlying asthma is not well-controlled.
Using Berodual only when your child is experiencing significant symptoms may not be the most effective approach. Asthma management typically involves a combination of long-term control medications (such as inhaled corticosteroids) and rescue medications (like Berodual) for acute symptoms. If your child frequently requires Berodual, it may be a sign that their asthma is not adequately controlled, and you should consult with your healthcare provider about adjusting their asthma management plan.

Proper Administration
For optimal effectiveness, Berodual should be used as directed by your healthcare provider. It is crucial to follow the prescribed dosage and frequency. If your child is using a nebulizer, ensure that the device is functioning correctly and that the medication is administered in a calm environment to facilitate better inhalation.

Conclusion
In summary, Berodual is a valuable medication for managing asthma in children, but it should be used appropriately and as part of a comprehensive asthma management plan. Regular follow-ups with your healthcare provider are essential to ensure that your child's asthma is well-controlled and to make any necessary adjustments to their treatment regimen. If you have concerns about your child's use of Berodual or their asthma management, do not hesitate to reach out to their healthcare provider for guidance.

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