Asthma Medication

Asthma Medications

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Asthma is a chronic (lifelong) disease that involves inflammation of the airways superimposed with recurrent episodes of limited airflow, mucus production, and cough.

Treatment focuses on:

• Taking medications that control inflammation and prevent chronic symptoms such as coughing or breathlessness at night, in the early morning, or after exertion (long-term control medications)
• Providing medications to treat asthma attacks when they occur (quick-relief medications)
• Avoiding asthma triggers
• Monitoring daily asthma symptoms in an asthma diary
• Monitoring peak flows

There are two general types of asthma medications which can give you long-term control or quick relief of symptoms.

• Anti-inflammatory drugs. This is the most important type of therapy for most people with asthma because these drugs prevent asthma attacks on an ongoing basis. Steroids, also called "corticosteroids," are an important type of anti-inflammatory medication for people suffering from asthma. These drugs reduce swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers.
• Bronchodilators. These medications relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways. This action rapidly opens the airways, letting more air come in and out of the lungs. As a result, breathing improves. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can be coughed out more easily.

These drugs can be administered in different ways to help control asthma. Successful treatment should allow you to live an active and normal life. If your asthma symptoms are not in good control, you should contact your doctor for advice.

NOTE: A newer asthma medicine drug, called Xolair, works by inhibiting the allergic reaction that often causes constriction of the airways. It works by blocking proteins in the immune system from becoming activated, an underlying cause of allergic asthma symptoms.

Long Term Control Medications: Treating the Inflammation

Doctors now recognize that asthma has two main components: airway inflammation and acute bronchoconstriction (constriction of the airways). Research has shown that reducing and preventing further inflammation is the key to preventing asthma attacks, hospitalizations and death from asthma.

Long-term control medications are taken daily over an extended period of time to achieve and maintain control of persistent asthma (asthma that causes symptoms more than twice a week and frequent attacks that affect activity).

The most effective long-term control medications are those that stop airway inflammation (anti-inflammatory drugs), but there are others that are often used along with anti-inflammatory drugs to enhance their effect.

Long-term control medications include:

• Corticosteroids (The inhaled form is the anti-inflammatory drug of choice for persistent asthma.)
• Mast cell stabilizers (anti-inflammatory drugs)
• Long acting beta-agonists (bronchodilators often used along with an anti-inflammatory drug)
• Theophylline (a bronchodilator used along with an anti-inflammatory drug to prevent nighttime symptoms)
• Leukotriene modifiers (an alternative to steroids and mast cell stabilizers)

Quick-Relief Medications: Stopping the Asthma Attack

These medicines are used to provide prompt relief of asthma attack symptoms (cough, chest tightness and wheezing -- all signs of airway bronchoconstriction).

They include:

• Short acting beta-agonists (bronchodilators that are the drug of choice to relieve asthma attacks and prevent exercise-induced asthma symptoms)
• Anticholinergics (bronchodilators used in addition to short-acting beta-agonists when needed or as an alternative to these drugs when needed)
• Systemic corticosteroids (an anti-inflammatory drug used in an emergency to get rapid control of the disease while initiating other treatments and to speed recovery)

Read more on bronchodilators and anti-inflammatory drugs.

Inhalers, Nebulizers, and Pills

Asthma medications can be either inhaled, using a metered dose inhaler, dry powder inhaler, or a nebulizer, or taken orally, either in pill or liquid form. A newer type asthma medication called Xolair is given by injection just under the skin.

Some asthma medications can be taken together. There are some inhalers that contain a combination of two different medications. These devices allow both medications to be delivered from one device, shortening treatment times and decreasing the number of inhalers needed to treat asthma symptoms.

Are There Over-the-Counter Asthma Medications?

Yes. The most common over-the-counter asthma medications are Primatene Mist and Bronkaid. They both work like a bronchodilator, relaxing the muscles around the airways. They provide short-term relief (20-30 minutes), but do not control asthma symptoms or prevent asthma attacks. People with high blood pressure, diabetes, thyroid disease, or heart disease should not take Primatene Mist or Bronkaid.

Unfortunately, many people misuse or overuse these medications. They are not meant for long-term use, yet some people use them every day to relieve asthma symptoms. Because they do not control asthma, people who take them may not be receiving proper treatment of their asthma.

If you are using an over-the-counter asthma medication but are experiencing frequent asthma symptoms, talk to your doctor. And if you are taking prescribed asthma medications but are using over-the-counter medications occasionally, tell your doctor this as well. You do not want to be taking more medicine than you need.

Can Allergy Shots Be Used to Treat Asthma?

Some recent studies have shown that when you give allergy shots to children with allergies, not only do their allergy symptoms improve, but they are also less likely to develop asthma. Also, since many cases of asthma are triggered by allergies, it makes sense that if you control the allergies, you will have fewer asthma attacks.

Ask your doctor if you are a candidate for allergy shots.

Will I Always Have to Take Asthma Medicines?

Asthma can't be cured. How often you need to take your asthma medication depends on how severe your asthma is and how frequently you have symptoms. For example, if your asthma symptoms occur only during the time of the year when your allergies act up, then you may only have to take medications to control your symptoms during that time. However, this is somewhat unusual, and most people with asthma need to take medications every daily.

Medication Guidelines

Asthma medications are the foundation of good asthma control. Learn all you can about your medications. Know what medications are included in your asthma action plan, when these medications should be taken, their expected results, and what to do when they fail. Here are some general guidelines to keep in mind:

• Refer to your asthma action plan when deciding how or when to use medications. This plan is designed so you achieve the best possible asthma control. Make sure you understand and can follow the plan.
• Wash your hands prior to preparing or taking medications.
• Take your time. Double-check the name and dosage of all your medications before using them.
• Keep your medications stored according to the instructions given with the prescription.
• Check liquid medications often. If they have changed color or formed crystals, throw them away and get new ones.
• Never run out of medications. Call your pharmacy or doctor's office at least 48 hours before running out. Know your pharmacy phone number, prescription numbers, and medication names and doses so that you can easily call for refills.
• Inform your doctor about any other medications you are taking. Some medications can affect the actions of others when taken together.
• Most asthma medications are very safe. However, side effects can occur and vary depending on the medication and dose. Ask your doctor or pharmacist to describe medication side effects. Report any unusual or severe side effects to your doctor immediately.

Reviewed by the doctors at The Cleveland Clinic Department of Pulmonary, Allergy and Critical Care Medicine.

Edited by Brunilda Nazario, MD, January 2006, WebMD.