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Asthma Treatment: Steroids and Other Anti-Inflammatory Drugs

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How Do Prednisone and Systemic Steroids Work to Increase Asthma Control?

Using systemic steroids (steroids taken by mouth or by injection that can affect the entire body) such as prednisone, prednisolone, and methylprednisolone helps to treat severe asthma episodes, allowing people to gain better asthma control. Prednisone and other steroid drugs may be used to help control sudden and severe asthma attacks or in rare cases to treat long-term, hard-to-control asthma.

Most often, prednisone or another steroid is taken in high doses for a few days (called a steroid burst) for more a severe asthma attack. 

Side effects of systemic steroids include weakness, acne, weight gain, mood or behavior changes, upset stomach, bone loss, eye changes, and slowing of growth. These side effects rarely occur with short-term use, such as for an acute asthma attack.

For in-depth information, see WebMD's article on Prednisone and Asthma.

How Do the Leukotriene Modifiers Improve Asthma Control?

Accolate, Singulair, and Zyflo are called leukotriene modifiers. Leukotrienes are inflammatory chemicals that occur naturally in our bodies and cause tightening of airway muscles and production of mucus. Leukotriene modifier drugs help control asthma by blocking the actions of leukotrienes in the body. Studies show that these medications are helpful in improving airflow and reducing asthma symptoms.

The leukotriene modifiers are taken as pills and have been shown to decrease the need for other asthma medications. These medications have been shown to be effective in people with allergic rhinitis (nasal allergies) and may be effective in people with both allergic rhinitis and allergic asthma.

What Are the Side Effects of Leukotriene Modifiers?

The most common side effects of leukotriene modifiers are headache, nausea, vomiting, insomnia, and irritability. Leukotriene modifiers may interfere with other medications (for example, theophylline and the blood thinner warfarin). Make sure you inform your doctor of all the medications you are taking. 

What Are the Mast Cell Stabilizers?

Mast cell stabilizers, such as cromolyn sodium, are inhaled asthma medications (asthma inhalers) that work by preventing the release of inflammatory substances (histamines) from immune cells called mast cells. They help prevent and reduce asthma symptoms, especially in children with allergies and asthma and in people with exercise-induced asthma. These asthma inhalers need to be taken two to four times a day, and they take 3 to 4 weeks to start working.

These asthma inhalers have side effects that include dry throat, cough, wheezing, throat irritation, and bad taste. 

How Do Immunomodulators Work to Improve Asthma Control?

Xolair (omalizumab), an immunomodulator, works differently from other anti-inflammatory medications for asthma. Xolair blocks the activity of IgE (a protein that is overproduced in people with allergies) before it can lead to asthma attacks. Immunomodulator treatment has been shown to help reduce the number of asthma attacks in people with moderate to severe allergic asthma whose symptoms are not controlled with inhaled steroids.

Xolair, a prescription medication, is given by injection every 2 to 4 weeks. It's recommended for people with moderate to severe allergic asthma. Side effects include redness, pain, swelling, bruising or itching at the injection site, joint pain, and tiredness. It may increase risk for certain cancers and carries a boxed warning about severe, potentially life-threatening allergic reaction (anaphylaxis). 

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WebMD Medical Reference

Reviewed by Varnada Karriem-Norwood, MD on December 16, 2012
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