I have had asthma since I was a small child. As time passed my symptoms thankfully improved but certainly through the years I have had an opportunity to take many different types of asthma medications. If you have been diagnosed with asthma your physician will no doubt order a variety of asthma medications to relieve your symptoms. These medicines are designed to help not only during times of an acute asthma attack, but certain ones will also keep your symptoms under control on a daily basis. For effective disease management it is important you know what your medications are.
What is asthma?
To best understand why you may need so many medications to control your asthma it helps to understand some of the dynamics involved with asthma. Asthma is a chronic respiratory disease that involves inflammation of the airway passages. According to Web MD, asthma affects some 22 million persons in America. During an acute attack of asthma, breathing passages become inflamed causing a narrowing of the airways. This hinders your ability to breathe oxygen into your lungs and causes symptoms such as wheezing, feeling of chest tightness, coughing and shortness of breath. Three major dynamics are at work that are responsible for the symptoms of asthma. These are 1) airway obstruction, 2) inflammation within the airways, and 3) irritability of the airway lining. The medications that are prescribed by your doctor are given to help one or more of these problems.
The inflammation in your airways is a chronic problem, that is, even when you are not having an acute attack of asthma your bronchial tubes still are sensitive and prone to becoming quickly inflamed. The medication your doctor prescribes will help keep this under control. The choice of medicines he prescribes will depend on how severe your symptoms are. Asthma medication comes in many forms including inhalers, tablets, liquids, granules and powders. Some asthma medicine can also be administered through an injection or given intravenously. Let’s take a look at some of the more common classifications of asthma medication:
Anti-inflammatories are one of the main drugs used in the treatment of asthma. Usually these are found in the form of steroids. Steroids not only help control the symptoms of asthma but also are helpful in preventing asthma attacks. As the name implies, anti-inflammatories lessen the amount of swelling and inflammation in the air passages, making them less sensitive. Corticosteroids act by blocking the production of allergy triggers. According to Medicine Net, topically inhaled steroids are a very effective method of managing asthma. Steroids are not without their side effects. They are known to impair the immune system and the function of white blood cells that are needed to ward off infection but overall they are very effective in treating asthma. Flovent, Azmacort and Pulmicort are examples of corticosteroids.
According to Web MD, bronchodilators are another important classification of medications given to asthmatics for both acute and chronic control of asthma. As the name implies the purpose of a bronchodilator is to open or dilate the air passages. During an asthma attack, the bronchial passages are constricted to a point where vital oxygen cannot get through. Bronchodilators can help clear out mucus in the lungs and allow the patient to cough out the mucus. There are really three classes of bronchodilators: 1) beta-2 agonists, 2) theophylline and 3) anticholinergics.
Beta-2 adrenergic agonists
Beta-2 adrenergic agonists, or beta agonists as they are often called, are a type of bronchodilator. They stimulate the nerves that supply the muscles around your bronchial tubes, causing them to relax, thus reducing the symptoms of an acute attack of asthma. According to the Mayo Clinic, some beta-2 adrenergic agonists are given in emergency situations, not only for asthma but for other severe allergic reactions such as anaphylaxis. The beta-2 agonists are given through a metered dose inhaler.
Short-acting versus long-acting beta-2 agonists
Short-acting beta-2 agonists are used as “rescue” medication when you need quick relief from acute asthma symptoms. They usually work within a couple of minutes. These include Albuterol (Proventil, Ventolin), Brethine, Alupent, Maxair and Xopenex. If you need to use your short-acting bronchodilators more than twice a week, talk with your doctor about improving your asthma controller therapy.
Long-acting beta-2 agonists are used as controllers of asthma symtpoms. They are not designed to be used for acute asthma attacks. Their effects can last up to 12 hours, so are often taken twice a day. Advair, Symbicort and Serevent are examples of long-acting beta-2 agonists. According to Medic 8, Serevent is often used in conjunction with an inhaled steroid. Although it takes longer to work, it is effective for a longer period of time.
Another type of bronchodilator is a classification of drugs known as methylxanthines, which also work by relaxing the airway muscle to decrease bronchospasm. According to eMedicine Health, most methylxanthines are long-acting medications and have a mild anti-inflammatory effect and are usually prescribed with other asthma medications. These medications usually are given orally in liquid or tablet form. Examples of methylxanthines include Theophylline, Slo-bid and Theo-Dur.
Anticholinergics also are a type of bronchodilator. These block certain chemical effects that will relieve bronchospasms by keeping the smooth muscles in the air passages from contracting and producing excess mucus. They are usually given via inhaler but in emergencies they can be given IV. These drugs are usually inhaled but can be given intravenously in the hospital. They are usually given along with a beta-2 agonist. Examples of anticholinergic drugs are Atrovent and Spiriva.
Central Nervous System (CNS) Stimulants
Some drugs that are central nervous system stimulants can be used to help improve asthma symptoms as they do have an effect on the airway passages, dilating the bronchials. According to Drugs.com, these works by reducing swelling and widening the airway, which helps you breathe more easily. Ephedrine is one type of CNS stimulant.
National Jewish Health describes leukotriene modifiers as medications that are used for controlling asthma on a long-term basis. These medications relax the smooth muscles around the bronchial tubes and help reduce swelling but might not work as effectively as inhaled steroids. Examples of Leukotriene modifiers are Zyflo and Singulair. These come in tablet form or granules. The granules come in a packet and are usually given to small children after being mixed with soft foods such as applesauce, ice cream, or rice.
Mast Cell Stabilizers
There are certain types of allergy cells known as mast cells. According to an article in Respiratory Review, mast cells are the main type of allergy cells that cause lower airway inflammation, smooth muscle contraction, bronchial constriction and mucous production which lead to asthma symptoms. The medications known as mast cell stabilizers keep mast cells from breaking open, thus keeping them from releasing the chemicals that cause inflammation in the lungs. The Palo Alto Medical Foundation confirms that mast cell stabilizers are slow-acting and may take weeks to work they so cannot be used as rescue medicines for acute asthma attacks. They are given via metered dose inhaler or nebulizer. Cromolyn is an example of a mast cell stabilizer.
Tips for taking your asthma medications
As you have noticed, there are many types of medications your doctor can prescribe for your asthma. Some are used to control your symptoms on a chronic or long-term basis. These will need to be taken every day, even if you are not having an acute attack. Other asthma medicines are considered rescue medications, and should only be used to for the immediate relief of acute symptoms.
If you find yourself using your rescue medicine more and more frequently you need to let your doctor know, as this means your asthma is worsening.
Always continue taking your control asthma medication even if you are not having symptoms.
Become familiar with your asthma medicine and be sure to talk to your doctor about anything concerning your medications that you do not understand.
eHealth Med: “Medications To Prevent Asthma Attacks”
Mayo Clinic: “Asthma medications: Know your options”
Medicine Net. “Asthma over-the-counter treatment”
Web MD: “Asthma, steroids and other anti-inflammatory drugs”
National Jewish Health: “Leukotriene modifiers”