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Treating Asthma – Medications

Treating Asthma – Medications

Generally medications are used to treat asthma, prevent asthma and control asthma symptoms, to reduce the number and severity of asthma episodes and to improve airflow. Mainly two types of asthma medications which are widely used:

Anti-inflammatory medicines

Anti-inflammatory medicines are the most essential medicines for most asthmatics(under Statistical). Anti-inflammatory medications reduce swelling and mucus production in the airways. As a solution, airways are less sensitive and less likely to react to asthma triggers. Anti-inflammatory medications need to be taken everyday and may need to be taken for several weeks before they will begin to control asthma and one can see results. Anti-inflammatories lead to fewer asthma symptoms, better airflow, less-sensitive airways, less airway damage and fewer asthma episodes. If taken daily, they control or prevent asthma symptoms.

Bronchodilators

Bronchodilators relax the muscle bands that tighten around the airways. This result vastly opens the airways, letting more air in and out of the lungs and improving breathing. It also aids in clearing mucus from the lungs. As the airways open, the mucus moves more freely and can be coughed out more easily. In short-acting forms, bronchodilators relieve or stop asthma symptoms and are very helpful during an asthma episode. In long-acting forms, bronchodilators provide control of asthma symptoms and prevent asthma episodes.

Every asthmatic patients will need both the above types of medication,unless it’s a mild case of asthma.

Theophylline is another type of  bronchodilator medication used to treat asthma.

 

Controller Medications

Inhaled corticosteroids (2)

Beta2-agonists (1) (long acting)

Mast cell stabilizers (2)

Anticholinergics (1)

Leukotriene modifiers (2)

 

Reliever Medications

Beta2-agonists (1) (short acting)

Oral corticosteroids (2) (for severe attacks)

Anticholinergics (1) (short acting)

Legend: ( 1)Bronchodilators  (2)Anti-inflammatory

 

asthma inhalers

Asthma Inhaler Usage

 

Anti-inflammatory medications

These medications are some of the most essential treatment options for people with asthma. It prevents asthma attacks and works by reducing swelling and mucus production in the airways. As a solution, airways are less sensitive and less likely to react to asthma triggers.Direct anti-inflammatory medications include inhaled and oral corticosteroids.

Inhaled corticosteroids

These are the most effective result medications to reduce airway inflammation and mucus production. The use of these medicines leads to better asthma control with fewer symptoms and flare-ups. Inhaled steroids prevent asthma symptoms, they do not relieve asthma symptoms.Inhaled steroids need to be taken daily for best results. Most results are seen in one to three weeks, with the best results seen after three months of everyday use.Consult your medical professionals for BETTER explanation and understanding.

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  1. marsha archer-james
    marsha archer-james07-15-2013

    my husband will often get severe asthmatic attack one of my friends recommended onions she said that he should smell a piece of it ond even try to chew a small piece when ever he feels an attact coming on and it helped him

    • Webmaster
      Webmaster07-18-2013

      Hello Marsha,

      Thanks for sharing the experience.

  2. Juneva E. Ramos
    Juneva E. Ramos07-16-2013

    is it safe to maintain these medication? what about the side effects ?

    • Webmaster
      Webmaster07-18-2013

      Hello Juneva,

      Thanks for the query.
      Medications taken under proper prescription and dosage evades side effects.

      Side effects of reliever medicines
      Relievers are a safe and effective medicine and have very few side effects. Some relievers can temporarily increase your heartbeat or give you mild muscle shakes. These effects are more common when taking high doses. However they generally wear off within a few minutes or a few hours at most.

      Side effects of preventer medicines
      The possibility of side effects from taking your inhaled preventer medicine is very low. Because the inhaled medicine goes straight down to the airways where it is needed, very little is absorbed into the rest of the body.

      If you use preventer medicine there is a small risk of having a sore tongue, sore throat, hoarseness of the voice and a mouth infection called thrush. To help prevent these side effects, rinse your mouth out and brush your teeth after using your preventer inhaler. Using a spacer will also help reduce the possibility of thrush.

      Children should be monitored closely if they are taking preventer medicines – especially for growth.

      It is possible that long-term and high-dose use of preventer medicines (inhaled steroids) may cause some other side effects (See ‘Side effects of long-term use of steroid tablets’, below). That is why your doctor and asthma nurse will try to keep you on the lowest dose to control your symptoms.

      Several studies have suggested the possibility of a very slight increased risk of the development of cataracts in elderly people who have used inhaled steroids. As with use of all medicines, careful attention needs to be paid to the risk versus benefit argument and it’s as likely that any risk can be reduced by always using the lowest possible dose of medication to control the condition.

      Side effects of steroid tablets

      Short term use
      For a small number of people, a short-term course of steroid tablets, can lower the body’s resistance to chickenpox, so you should contact your doctor if you or your child are taking steroid tablets and you/they come into contact with chickenpox. If your doctor thinks you are at risk they can give you an injection to protect you.

      Other possible side effects from taking a short course of steroid tablets are mood swings (especially in children) and increased hunger.

      There are very few other side effects from taking occasional (three to four) short courses of steroids per year. However it is important to keep the number of courses to a minimum by making sure you are using enough of your other regular inhaled medicines.

      Long term use
      A small minority of people with severe asthma need to take steroid tablets for a longer period. However, taking steroid tablets regularly, for long periods of time (months or years) can have serious side effects for some people.

      For these reasons your doctor and asthma nurse will always try to prescribe the smallest possible dose of daily steroid tablets. It is very important that you continue to take your other asthma treatments regularly to keep the need for steroid tablets to a minimum.

      If you have severe asthma and you have been prescribed long-term steroid tablets your doctor and asthma nurse should discuss and consult with you about the risk of side effects against the benefits of controlling your asthma symptoms (if untreated, severe asthma can lead to permanent lung damage).

      The possible side effects of long-term use of steroid tablets are:

      Fattened face (moon face)
      Feeling hungry and wanting to eat more (this extra eating can lead to weight gain)
      Feeling ‘hyped up’ and over active with difficulty sleeping
      Feeling depressed or having sudden mood swings
      Heartburn and indigestion
      Bruising easily
      Brittle bones (osteoporosis)
      Altering diabetic control or uncovering a tendency to diabetes
      Chickenpox may be more serious
      Risk of cataract increases
      Steroid tablets do not have any side effects that damage the heart.

      What can I do about side effects of steroid tablets?

      Most importantly, don’t smoke. If you smoke, bone thinning side effects are worse. Your general asthma control will also be helped if no one in your household smokes. If your partner gives up smoking, it may mean you can cut down on your dose of steroid tablet.
      Taking steroid tablets first thing in the morning may have some benefit in decreasing side effects.
      People who need to take regular steroid tablets can use daily calcium supplements, although there is no clear scientific evidence to prove that these are useful.
      Weight-bearing exercise, such as walking for 20 minutes each day will help protect against the bone thinning effect of long-term steroids.

      Dr.Kamz MD

  3. Lee chairim
    Lee chairim04-06-2014

    Thank so much

    • Webmaster
      Webmaster04-06-2014

      Hello Lee chairim,

      You are welcome and thank you so much for your support.

      Webmaster

  4. Sherif
    Sherif09-26-2014

    My wife uses these two drugs to control her asthma CELESTENE 2 mg and CALMIXENE she is visiting me for 3 months from Senegal and forgot her drugs. I’ve gone to various pharmacy but could not find these drugs can you please recommend equivalent drugs I can buy for her with the same result. Hoping for you prompt response

    • Webmaster
      Webmaster09-27-2014

      Hello Sherif,

      Thanks for your query.
      Every asthma patients must consult a doctor-even if one is at another continent.No medicine is best medicine in any case or a replacement without the consultation of a physician.So,take the below guide as a asthma action plan:

      How Is Asthma Treated and Controlled?
      Asthma is a long-term disease that has no cure. The goal of asthma treatment is to control the disease. Good asthma control will:

      Prevent chronic and troublesome symptoms, such as coughing and shortness of breath
      Reduce your need for quick-relief medicines (see below)
      Help you maintain good lung function
      Let you maintain your normal activity level and sleep through the night
      Prevent asthma attacks that could result in an emergency room visit or hospital stay
      To control asthma, partner with your doctor to manage your asthma or your child’s asthma. Children aged 10 or older—and younger children who are able—should take an active role in their asthma care.

      Taking an active role to control your asthma involves:

      Working with your doctor to treat other conditions that can interfere with asthma management.
      Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active.
      Working with your doctor and other health care providers to create and follow an asthma action plan.
      An asthma action plan gives guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms, and seeking emergency care when needed.

      Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or “rescue,” medicines relieve asthma symptoms that may flare up.

      Your initial treatment will depend on the severity of your asthma. Followup asthma treatment will depend on how well your asthma action plan is controlling your symptoms and preventing asthma attacks.

      Your level of asthma control can vary over time and with changes in your home, school, or work environments. These changes can alter how often you’re exposed to the factors that can worsen your asthma.

      Your doctor may need to increase your medicine if your asthma doesn’t stay under control. On the other hand, if your asthma is well controlled for several months, your doctor may decrease your medicine. These adjustments to your medicine will help you maintain the best control possible with the least amount of medicine necessary.

      Asthma treatment for certain groups of people—such as children, pregnant women, or those for whom exercise brings on asthma symptoms—will be adjusted to meet their special needs.

      Follow an Asthma Action Plan

      You can work with your doctor to create a personal asthma action plan. The plan will describe your daily treatments, such as which medicines to take and when to take them. The plan also will explain when to call your doctor or go to the emergency room.

      Avoid Things That Can Worsen Your Asthma
      Many common things (called asthma triggers) can set off or worsen your asthma symptoms. Once you know what these things are, you can take steps to control many of them.

      For example, exposure to pollens or air pollution might make your asthma worse. If so, try to limit time outdoors when the levels of these substances in the outdoor air are high. If animal fur triggers your asthma symptoms, keep pets with fur out of your home or bedroom.

      One possible asthma trigger you shouldn’t avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active.

      If your asthma symptoms are clearly related to allergens, and you can’t avoid exposure to those allergens, your doctor may advise you to get allergy shots.

      You may need to see a specialist if you’re thinking about getting allergy shots. These shots can lessen or prevent your asthma symptoms, but they can’t cure your asthma.

      Several health conditions can make asthma harder to manage. These conditions include runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Your doctor will treat these conditions as well.

      Medicines

      Your doctor will consider many things when deciding which asthma medicines are best for you. He or she will check to see how well a medicine works for you. Then, he or she will adjust the dose or medicine as needed.

      Asthma medicines can be taken in pill form, but most are taken using a device called an inhaler. An inhaler allows the medicine to go directly to your lungs.

      Not all inhalers are used the same way. Ask your doctor or another health care provider to show you the right way to use your inhaler. Review the way you use your inhaler at every medical visit.

      Long-Term Control Medicines
      Most people who have asthma need to take long-term control medicines daily to help prevent symptoms. The most effective long-term medicines reduce airway inflammation, which helps prevent symptoms from starting. These medicines don’t give you quick relief from symptoms.

      Inhaled corticosteroids. Inhaled corticosteroids are the preferred medicine for long-term control of asthma. They’re the most effective option for long-term relief of the inflammation and swelling that makes your airways sensitive to certain inhaled substances.

      Reducing inflammation helps prevent the chain reaction that causes asthma symptoms. Most people who take these medicines daily find they greatly reduce the severity of symptoms and how often they occur.

      Inhaled corticosteroids generally are safe when taken as prescribed. These medicines are different from the illegal anabolic steroids taken by some athletes. Inhaled corticosteroids aren’t habit-forming, even if you take them every day for many years.

      Like many other medicines, though, inhaled corticosteroids can have side effects. Most doctors agree that the benefits of taking inhaled corticosteroids and preventing asthma attacks far outweigh the risk of side effects.

      One common side effect from inhaled corticosteroids is a mouth infection called thrush. You might be able to use a spacer or holding chamber on your inhaler to avoid thrush. These devices attach to your inhaler. They help prevent the medicine from landing in your mouth or on the back of your throat.

      Check with your doctor to see whether a spacer or holding chamber should be used with the inhaler you have. Also, work with your health care team if you have any questions about how to use a spacer or holding chamber. Rinsing your mouth out with water after taking inhaled corticosteroids also can lower your risk for thrush.

      If you have severe asthma, you may have to take corticosteroid pills or liquid for short periods to get your asthma under control.

      If taken for long periods, these medicines raise your risk for cataracts and osteoporosis (OS-te-o-po-RO-sis). A cataract is the clouding of the lens in your eye. Osteoporosis is a disorder that makes your bones weak and more likely to break.

      Your doctor may have you add another long-term asthma control medicine so he or she can lower your dose of corticosteroids. Or, your doctor may suggest you take calcium and vitamin D pills to protect your bones.

      Other long-term control medicines. Other long-term control medicines include:

      Cromolynexternal link icon. This medicine is taken using a device called a nebulizer. As you breathe in, the nebulizer sends a fine mist of medicine to your lungs. Cromolyn helps prevent airway inflammation.
      Omalizumabexternal link icon (anti-IgE). This medicine is given as a shot (injection) one or two times a month. It helps prevent your body from reacting to asthma triggers, such as pollen and dust mites. Anti-IgE might be used if other asthma medicines have not worked well.
      A rare, but possibly life-threatening allergic reaction called anaphylaxis might occur when the Omalizumab injection is given. If you take this medication, work with your doctor to make sure you understand the signs and symptoms of anaphylaxis and what actions you should take.

      Inhaled long-acting beta2-agonistsexternal link icon. These medicines open the airways. They might be added to inhaled corticosteroids to improve asthma control. Inhaled long-acting beta2-agonists should never be used on their own for long-term asthma control. They must used with inhaled corticosteroids.
      Leukotriene modifiersexternal link icon. These medicines are taken by mouth. They help block the chain reaction that increases inflammation in your airways.
      Theophyllineexternal link icon. This medicine is taken by mouth. Theophylline helps open the airways.
      If your doctor prescribes a long-term control medicine, take it every day to control your asthma. Your asthma symptoms will likely return or get worse if you stop taking your medicine.

      Long-term control medicines can have side effects. Talk with your doctor about these side effects and ways to reduce or avoid them.

      With some medicines, like theophylline, your doctor will check the level of medicine in your blood. This helps ensure that you’re getting enough medicine to relieve your asthma symptoms, but not so much that it causes dangerous side effects.

      Quick-Relief Medicines
      All people who have asthma need quick-relief medicines to help relieve asthma symptoms that may flare up. Inhaled short-acting beta2-agonistsexternal link icon are the first choice for quick relief.

      These medicines act quickly to relax tight muscles around your airways when you’re having a flareup. This allows the airways to open up so air can flow through them.

      You should take your quick-relief medicine when you first notice asthma symptoms. If you use this medicine more than 2 days a week, talk with your doctor about your asthma control. You may need to make changes to your asthma action plan.

      Carry your quick-relief inhaler with you at all times in case you need it. If your child has asthma, make sure that anyone caring for him or her has the child’s quick-relief medicines, including staff at the child’s school. They should understand when and how to use these medicines and when to seek medical care for your child.

      You shouldn’t use quick-relief medicines in place of prescribed long-term control medicines. Quick-relief medicines don’t reduce inflammation.

      Track Your Asthma

      To track your asthma, keep records of your symptoms, check your peak flow number using a peak flow meter, and get regular asthma checkups.

      Record Your Symptoms
      You can record your asthma symptoms in a diary to see how well your treatments are controlling your asthma.

      Asthma is well controlled if:

      You have symptoms no more than 2 days a week, and these symptoms don’t wake you from sleep more than 1 or 2 nights a month.
      You can do all your normal activities.
      You take quick-relief medicines no more than 2 days a week.
      You have no more than one asthma attack a year that requires you to take corticosteroids by mouth.
      Your peak flow doesn’t drop below 80 percent of your personal best number.
      If your asthma isn’t well controlled, contact your doctor. He or she may need to change your asthma action plan.

      Use a Peak Flow Meter
      This small, hand-held device shows how well air moves out of your lungs. You blow into the device and it gives you a score, or peak flow number. Your score shows how well your lungs are working at the time of the test.

      Your doctor will tell you how and when to use your peak flow meter. He or she also will teach you how to take your medicines based on your score.

      Your doctor and other health care providers may ask you to use your peak flow meter each morning and keep a record of your results. You may find it very useful to record peak flow scores for a couple of weeks before each medical visit and take the results with you.

      When you’re first diagnosed with asthma, it’s important to find your “personal best” peak flow number. To do this, you record your score each day for a 2- to 3-week period when your asthma is well-controlled. The highest number you get during that time is your personal best. You can compare this number to future numbers to make sure your asthma is controlled.

      Your peak flow meter can help warn you of an asthma attack, even before you notice symptoms. If your score shows that your breathing is getting worse, you should take your quick-relief medicines the way your asthma action plan directs. Then you can use the peak flow meter to check how well the medicine worked.

      Get Asthma Checkups
      When you first begin treatment, you’ll see your doctor about every 2 to 6 weeks. Once your asthma is controlled, your doctor may want to see you from once a month to twice a year.

      During these checkups, your doctor may ask whether you’ve had an asthma attack since the last visit or any changes in symptoms or peak flow measurements. He or she also may ask about your daily activities. This information will help your doctor assess your level of asthma control.

      Your doctor also may ask whether you have any problems or concerns with taking your medicines or following your asthma action plan. Based on your answers to these questions, your doctor may change the dose of your medicine or give you a new medicine.

      If your control is very good, you might be able to take less medicine. The goal is to use the least amount of medicine needed to control your asthma.

      Emergency Care

      Most people who have asthma, including many children, can safely manage their symptoms by following their asthma action plans. However, you might need medical attention at times.

      Call your doctor for advice if:

      Your medicines don’t relieve an asthma attack.
      Your peak flow is less than half of your personal best peak flow number.

      You have trouble walking and talking because you’re out of breath.
      You have blue lips or fingernails.
      At the hospital, you’ll be closely watched and given oxygen and more medicines, as well as medicines at higher doses than you take at home. Such treatment can save your life.

      Asthma Treatment for Special Groups

      The treatments described above generally apply to all people who have asthma. However, some aspects of treatment differ for people in certain age groups and those who have special needs.

      Inhaled corticosteroids are the preferred treatment for young children. Montelukast and cromolyn are other options. Treatment might be given for a trial period of 1 month to 6 weeks. Treatment usually is stopped if benefits aren’t seen during that time and the doctor and parents are confident the medicine was used properly.

      Inhaled corticosteroids can possibly slow the growth of children of all ages. Slowed growth usually is apparent in the first several months of treatment, is generally small, and doesn’t get worse over time. Poorly controlled asthma also may reduce a child’s growth rate.

      Older Adults
      Doctors may need to adjust asthma treatment for older adults who take certain other medicines, such as beta blockers, aspirin and other pain relievers, and anti-inflammatory medicines. These medicines can prevent asthma medicines from working well and may worsen asthma symptoms.

      Be sure to tell your doctor about all of the medicines you take, including over-the-counter medicines.

      Older adults may develop weak bones from using inhaled corticosteroids, especially at high doses. Talk with your doctor about taking calcium and vitamin D pills, as well as other ways to help keep your bones strong.

      Pregnant Women
      Pregnant women who have asthma need to control the disease to ensure a good supply of oxygen to their babies. Poor asthma control increases the risk of preeclampsia, a condition in which a pregnant woman develops high blood pressure and protein in the urine. Poor asthma control also increases the risk that a baby will be born early and have a low birth weight.

      Studies show that it’s safer to take asthma medicines while pregnant than to risk having an asthma attack.

      Talk with your doctor if you have asthma and are pregnant or planning a pregnancy. Your level of asthma control may get better or it may get worse while you’re pregnant. Your health care team will check your asthma control often and adjust your treatment as needed.

      People Whose Asthma Symptoms Occur With Physical Activity
      Physical activity is an important part of a healthy lifestyle. Adults need physical activity to maintain good health. Children need it for growth and development.

      In some people, however, physical activity can trigger asthma symptoms. If this happens to you or your child, talk with your doctor about the best ways to control asthma so you can stay active.

      The following medicines may help prevent asthma symptoms caused by physical activity:

      Short-acting beta2-agonists (quick-relief medicine) taken shortly before physical activity can last 2 to 3 hours and prevent exercise-related symptoms in most people who take them.
      Long-acting beta2-agonists can be protective for up to 12 hours. However, with daily use, they’ll no longer give up to 12 hours of protection. Also, frequent use of these medicines for physical activity might be a sign that asthma is poorly controlled.
      Leukotriene modifiers. These pills are taken several hours before physical activity. They can help relieve asthma symptoms brought on by physical activity.
      Long-term control medicines. Frequent or severe symptoms due to physical activity may suggest poorly controlled asthma and the need to either start or increase long-term control medicines that reduce inflammation. This will help prevent exercise-related symptoms.
      Easing into physical activity with a warmup period may be helpful. You also may want to wear a mask or scarf over your mouth when exercising in cold weather.

      If you use your asthma medicines as your doctor directs, you should be able to take part in any physical activity or sport you choose.

      People Having Surgery
      Asthma may add to the risk of having problems during and after surgery. For instance, having a tube put into your throat may cause an asthma attack.

      Tell your surgeon about your asthma when you first talk with him or her. The surgeon can take steps to lower your risk, such as giving you asthma medicines before or during surgery.

      By NHLBI

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