Medicine plays a vital role in the treatment of asthma. There are two basic types of asthma medication – anti-inflammatory medicines and bronchodilators. Anti-inflammatory medicines, also known as long-term controller medicines, have a slow but long-lasting effect. They work to reduce inflammation of the airways. But they have to be used on a regular basis for satisfactory results. Patients with chronic asthma need to take these medications daily. These medicines are used to prevent asthma attacks from starting but cannot stop them once they begin.
The second type, Bronchodilators or quick-relief medicines work fast to remove bronchoconstriction and clear the airways. They are used to stop asthma attacks once they begin but are not very helpful in reducing chronic inflammation that makes the bronchial tubes sensitive. The type of asthma that you have will determine the type of medication you need. Chronic asthma patients may even require a combination of fast-relief and long-term medicines.
Asthma medicines are available as inhalers, pills, liquids and injections. Medicines that are available in liquid or pill form can produce many body side effects. But inhaled medicines have lesser overall side effects as they go directly into the lungs. Medications also vary depending on their onset of action and the peak effect time. The choice of medication also depends on cost and benefit to the patient.
Anti-Inflammatory Medications:
Patients with asthma are generally advised controller medicines or long-term preventive medicine. They are required to take these medications on a daily basis to reduce inflammation and irritation of the airways and improve breathing.
The following are some anti-inflammatory medicines:
Corticisteroids – The most preferred way of treating inflamed airways and preventing irritation in chronic asthma patients is the use of inhaled corticosteroids. This type of steroid is related to cortisone – a hormone produced by the adrenal glands. Corticosteroids block the inflammation causing chemicals in your body and require a week or more to start showing results. They affect the lungs and are hence safe for long-term use. But you need to consult your doctor before switching from any oral steroid like prednisone, to an inhaled steroid as you may face difficulties handling stress related to surgery and trauma. For this you may require some additional systemic steroids.
Although inhaled corticosteroids do not produce the potentially severe side effects that are produced by a regular use of the oral ones, they can give rise to side effects such as hoarseness of voice and mouth irritation. These can be reduced by rinsing the mouth with water and spitting out after inhalation of the medicine. Additional side effects of long-term usage include increased risk of cataract and glaucoma as well as growth retardation in children.
Cromolyn Sodium And Nedocromil Sodium – Regular use of these medicines prevents the activation of messages that induce an immune system reaction. But they are less effective than inhaled steroids. They can be used before exposure to allergic conditions or exercise also.
Beta-Agonist Inhaler – By stimulating the airways muscles, these medicines prevent constriction and help the bronchial tubes relax. Long-term beta-agonists are given to patients with moderate or severely chronic asthma to prevent night-time and exercise-induced symptoms.
Fast-Relief Medicines:
These medicines act quickly to control an asthma attack. They are generally available as inhalators that work to clear the airways and normalize breathing. This provides quick relief from asthma symptoms like coughing, shortness of breath and wheezing within a few minutes. This type of medication is not meant for regular use. It should be used as and when the symptoms flare up. There are two types of quick-relief medications:
Anticholinergics – They relax the airways muscles to reverse the constriction and spasms of the bronchial muscles. Inhaled antichloinergics are usually used in addition to inhaled Beta2-agonists in patients having severe asthma attacks.
Beta2-Agonists – These are supposed to be the most effective bronchdilators. These medicines act specifically on the B2 receptors in the muscles surrounding the bronchial tubes. Their action reverses broncho-constriction and normalizes breathing by relaxing the muscles. These medicines also slow down the release of histamines and increase the body's ability to clear the excessive mucus. Their effect lasts for up to four hours.
Beta2-agonists - are administered as per need during an asthma attack. Need for excessive use indicates improper inhaler use or need for additional medication. Some side effects include rapid heartbeat and shaking, which can wear off after some time.