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Asthma

Understanding asthma medications

Asthma medications are grouped into two categories: long-term (maintenance) medications and quick-relief (rescue) medications. Since asthma is a long-term, or chronic condition, practical long-term treatments are necessary to continue living an active lifestyle. Quick relief medications are used to treat acute asthma attacks that may happen suddenly and with greater severity.

Depending on your condition, your doctor will prescribe the type of medication that is appropriate for you.

Long-term (maintenance) medications

Corticosteroids

Medications found to be the most effective are those that have an anti-inflammatory effect. Inhaled corticosteroids are the most commonly used anti-inflammatory medications. These medicines are based on a hormone your body produces naturally — they are NOT related to the anabolic steroids that are sometimes misused by athletes to increase muscle mass.

Corticosteroids are very effective in routine asthma control and maintenance because they provide treatment for inflammation. While they cannot be used to treat an asthma episode, corticosteroids can reduce the airway inflammation that can cause symptoms.

There are many different forms of corticosteroids: inhalants, tablets, suppositories, liquids and injections. If you're using a long-acting inhaled beta2-agonist in addition to a corticosteroid, do not discontinue taking your corticosteroid without consulting your doctor first — even if you're feeling better.

Some common side effects of the oral medications may include increased appetite, water retention and weight gain. When using inhaled medications, common side effects are yeast infections in the mouth, sore throat, hoarseness and coughing. You may be able to minimize the risk of yeast infections by rinsing your mouth with water after every use.

NOTE: Anti-inflammatory medications are not intended to be used to provide rapid relief of symptoms. These drugs are long-acting agents that cannot relieve symptoms once they have begun.

Long-acting beta2-agonists

This type of bronchodilator is for those who suffer from frequent episodes of asthma. Long-acting inhaled beta2-agonists are intended to help prevent asthma symptoms from occurring. They relax the muscles surrounding your airways, allowing them to open more fully, so you can breathe more freely. When used regularly, a long-acting beta2-agonist can help to reduce the risk of sudden symptoms.

This type of medication is usually administered once in the morning and once in the evening, about 12 hours apart. Some common side effects are tremor, cough and headache.

Long-acting bronchodilators are available as pills and inhalants. People on long-acting beta2 therapy most commonly use inhalers.

NOTE: Long-acting bronchodilators should never be used to treat sudden symptoms. They cannot act fast enough to provide rapid relief.

Methylxanthines (theophylline)

A commonly used type of oral asthma medication is theophylline. It is available in a range of different doses to allow your doctor to prescribe the exact amount to treat your symptoms with the fewest side effects. Theophylline can be prescribed as either a short-acting or long-acting medication. Some common side effects are nausea, headache, restlessness and rapid heartbeat. Your doctor should order lab tests periodically to measure drug concentrations in the bloodstream.

Leukotriene modifiers

Leukotriene modifiers are used for the long-term control and prevention of asthma symptoms. As always, be sure to tell your doctor about all medications you are taking. This medication may interfere with or decrease the effectiveness of your other medications. Your doctor may also want to monitor the function of your liver while you are taking some of these medications.

Cromolyn sodium / nedocromil sodium

These anti-inflammatory agents are known as mast cell stabilizers and may be used as an initial choice for long-term control therapy in children. They can also be used as preventive treatment prior to exercise or unavoidable exposure to known allergens.

Quick-relief (rescue) medications

Short-acting beta2-agonists

Like the long-acting beta2-agonists, these short-acting bronchodilators also relax the muscles surrounding your airways. However, they act almost immediately to relieve symptoms that are caused by asthma triggers. The peak of relief is reached within two hours after dosing, and the medication can be taken as needed as often as every four hours during the day.

Short-acting inhaled beta2-agonists are often prescribed for people who have only occasional asthma episodes — once or twice a week — and who remain symptom-free the rest of the time. Some common side effects are tremor, cough and headache.

Short-acting bronchodilators are also available as pills, liquids, inhalants and injections. People on short-acting beta2 therapy most commonly use inhalers.

NOTE: If you find that you are using a short-acting drug more than two or three times per week, this may be a sign that your asthma is not under control. You should talk with your doctor about better long-term asthma management techniques.

Anticholinergic drugs

Anticholinergic drugs may be an alternative for patients who cannot tolerate inhaled short-acting beta2-agonists. These drugs work by expanding your air passages (reversing bronchoconstriction) and may also decrease mucous gland secretion, making it easier to breathe. This medication is not indicated for the treatment of asthma and should not be used for quick-relief asthma episodes. A common side effect is drying of the mouth.

Systemic corticosteroids

Systemic corticosteroids are used to treat moderate to severe asthma episodes. They have an anti-inflammatory action, which helps reverse inflammation and speed your recovery from an episode. They also help reduce the chance of a recurrence. Some common side effects are increased appetite, water retention and weight gain. As always, tell your doctor about any other conditions you have — even if they seem minor — before taking this medication.

Source: "Understanding Asthma Medications," © 2000, 2001 The GlaxoSmithKline Group of Companies.

Resources available:

Peak flow meters are available free to Blue Cross and Blue Shield of Oklahoma and BlueLincs HMO members.For information about how to obtain a free peak flow meter or for more information about the asthma health promotion program, e-mail us or call toll-free 1-866-670-6681.