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Asthma Medications

Can Medicine Cure My Asthma?

No, there is no cure for asthma. Although asthma cannot be cured it can be controlled. There are many medicines that help people with asthma. Some are preventive medicines and others are known as quick relievers. The preventive medicines are used for long-term control of the disease and work to make asthma attacks less frequent and less severe. Quick reliever medicines offer short-term relief of symptoms when asthma episodes occur.

Unless your asthma is very mild, chances are you have prescriptions for at least two different medicines. That can be confusing. The more you understand about what those medicines do and why they help, the more likely you are to use them correctly.

Although there are some potential unfavorable side effects from taking asthma medications, the benefit of successfully controlling your asthma outweighs the risks. It is important to discuss each of your asthma medications with your physician to learn more about their effects.

As just discussed, there are two kinds of asthma medications: long term controllers and quick relievers.

Long-term Control Medicines

Standard asthma treatment begins with long-term relief from antiinflammatory drugs. These drugs make the airways less sensitive, and keeps them from reacting as easily to triggers. They reduce coughing, wheezing and the struggle for breath, and they allow you to live an active life. To have long-term control of your asthma depends on you. Anti-inflationary drugs must be taken exactly as they are prescribed.

Cromolyn Sodium (Inhaled: Intal) and Nedocromil Sodium (Inhaled: Tilade) prevent airways from swelling when they come in contact with asthma triggers. These nonsteroids can also be used to prevent asthma caused by exercise.

Inhaled Corticosteroids (Aerobid, Azmacort, Beclovent, Flovent, Pulmicort, Vanceril) prevent and reduce airway swelling and decrease the amount of mucus in the lungs. These are generally safe when taken as directed. They are not the same as anabolic steroids, which some athletes take to build muscles.

If you are taking an inhaled antiinflammatory medicine and you feel your asthma symptoms getting worse, talk with your doctor about continuing or increasing the medicine that you are already taking. You may also need to add an oral corticosteroid or a short-acting beta antagonist (bronchodilator) for relief.

Oral Corticosteroids—(Pills or tablets: Aristocort, Celestone, Decadron, Medrol, Prednisone, Sterapred) (Liquid for children: Pediapred, Prelone) are used as short-term treatment for severe asthma episodes or as long-term therapy for some people with severe asthma. Again, these are not the same as anabolic steroids.

Long-acting beta agonists—(Inhaled: Serevent) can be taken with or without an antiinflammatory medicine to help control daily symptoms, including nighttime asthma. This type of medicine can also prevent asthma triggered by exercise.

Because long-acting beta agonists can not relieve symptoms quickly, they should not be used for an acute attack. You also need a short-acting, inhaled beta agonist for acute symptoms.

Long-acting, inhaled beta agonists are not a substitute for antiinflammatory medicine. You should not decrease or stop taking your antiinflammatory medicine without talking to your doctor, even if you feel better.

Leukotriene modifiers  (Tablets: Accolate, Singulair) are a new type of long-term control medication. They prevent airway inflammation and swelling, decrease the amount of mucus in the lungs and open the airways.

Combined therapy medicine (inhaled) contains both a controller and reliever medicine.  This combination of a long-acting bronchodilator and corticosteroid is used for long-term control. 

Anti-IgE therapy (injected) is a new treatment for people with moderate or severe allergic asthma.  It attempts to stop allergic asthma at its root cause instead of just treating asthma symptoms. This drug is not inhaled, but rather injected by your doctor on a regular basis.  It does not eliminate your need for other asthma medications, but it can help to reduce your use of them. Due to its significant cost, this form of therapy is currently reserved for moderate to severe cases requiring multiple medications.

Quick Relief Medicines

These medicines ease the wheezing, coughing and tightness of the chest that occurs during asthma episodes.

Short acting brochodilators are one type of quick relief medicines. They open airways by relaxing muscles that tighten in and around the airways during asthma episodes.

Short-acting beta agonists (Inhaled: Albuterol, Alupent, Brethaire, Bronkosol, Isoetharine, Maxair, Medihaler-Iso, Metaprel, Proventil, Tornalate, Ventolin) relieve asthma symptoms quickly and some prevent asthma caused by exercise.

If you use one of these medicines every day, or if you use it more than three times in a single day, your asthma may be getting worse, or you may not be using your inhaler correctly. Talk with your doctor right away about adding or increasing a medication, and about your inhaler technique.

Oral beta agonists (Syrup, tablets and long-acting tablets: Alupent, Brethine, Bricanyl, Proventil, Proventil Repetabs, Ventolin, Volmax). Syrup may be used for children, while long-acting tablets may be used for nighttime asthma. Oral preparations generally cause more side effects than the inhaled form.

Theophylline (Oral, slow acting: Aerolate, Elixophyllin, Quibron-T, Resbid, Slo-bid, T-Phyl, Theolair, Theo-24, Theo-Dur, Theo-X, Uni-Dur, Uniphyl) can be used for persistently symptomatic asthma, and especially to prevent nighttime asthma. Theophylline must remain at a constant level in the blood stream to be effective. Too high a level can be dangerous. Your doctor will do regular blood tests. Sustained release Theophylline is not the preferred primary long-term control treatment, but it is effective when added to other antiinflammatory medicines to control nighttime episodes.

The job of these medicines is to control your asthma in both normal and stressful situations so that your airways remain open and your lungs operate properly. This enables you to live an active life free from fear of struggling for breathe. But for the medicines to do their best work, you must understand your condition, know what your medicines can and cannot do, and use them exactly as instructed by your doctor. Your intelligent use of asthma medicines is as important as the medicines themselves!

Can Medicine Alone Help My Asthma?

No. Although medicines help a lot, you cannot expect them to do the job alone. You have to help. You have to avoid the things that cause (or trigger) your asthma symptoms as much as you can, even if they are things you like. In planning to avoid these triggers, you need to think about outdoor exposure as well as the things at home and at work that cause your problem.

Will I Always Have to Take the Same Amount of Medicine?

Not necessarily. You will probably take most when you begin treatment, while your doctor learns what causes your asthma, which medicine(s) control it most effectively and at what doses. Once this is completed, your medications may be reduced in number, frequency or dose. The goal of this "step-down" method is to gain control of your asthma as quickly as possible, then maintain effective control with as little medication as necessary. Once long-term, antiinflammatory therapy has begun, proper monitoring requires examination by a doctor every 1 to 6 months.

Will I Have to Take Medicine All the Time?

Not necessarily. Because asthma is a chronic condition that is controllable but currently can not be cured, you will have asthma all the time even if your are symptom free much of the time. Your medical treatment will take into consideration the severity and frequency of your symptoms. If you have little inflammation between episodes, and if the episodes are infrequent, your treatment will emphasize quick relief from acute symptoms, particularly if they are mild.

If your symptoms occur at certain times and from a known and predictable cause, you will be treated accordingly. If, for example, you have "seasonal asthma" because of an allergy to a specific pollen, you may take medicines only when that pollen is in the air. But asthma so specific is uncommon, and most people with asthma take some form of medication most or all of the time.

Will Medicine Help Me Sleep Better?

Yes. It is common for asthma symptoms to occur at night, and many people tell of the panic of awakening in a struggle for breath. These nighttime symptoms can be controlled with asthma medicines taken on a regular basis.

In addition, some bedding materials may be among your allergens, and must be replaced with non-allergenic materials. Air filters in your bedroom may also help to maximize the benefits of your medicines if you have nighttime symptoms of asthma.

Will Medicines Help Me Breathe Better When I Exercise?

Yes. Physical activity, especially when combined with an irritant like cold air, may cause your airways to open and close irregularly. This is called exertion-induced bronchospasm (EBI). The short-term-relief asthma medicines, taken before and during exercise, usually control this. Thanks to these medicines, many Olympic and professional athletes enjoy successful sports careers despite their asthma.

Do Asthma Drugs Have Side Effects?

Yes, as do all drugs. No medicine is so exact that it can do its intended job without having unintended side effects as well. It is important, therefore, that you give your doctor accurate information about your entire health condition, not just your asthma symptoms. Doing away with some asthma drugs on the basis of other health problems, like high blood pressure, is one important way of reducing your risks.

For most people with asthma, long-term control of inflammation of the airways is the key to successful treatment. Prescribing drugs based on information you supply is your doctor's responsibility. Faithful reporting of changes and reactions is yours. And only you can make sure that you take your medication exactly as it is prescribed.

The greatest danger for most people taking asthma medicine, especially by inhaler, is overuse. Don't give in to "just another puff," or "if two puffs work, three must be better," or "half a dose between doses." Overuse of these medications over a period of years may prove to be very harmful.

Your doctor, your pharmacist, and the medicine's label will tell you exactly the frequency and amount of your doses. Do not exceed them without your doctor's instructions. If either your doctor or pharmacist says that "you are going through this awfully quickly," you are almost certainly overusing. Overusing is overdosing.

 

 

SOURCE: This information should not substitute for seeking responsible, professional medical care. First created 1995; fully updated 1998; most recently updated 2005.
© Asthma and Allergy Foundation of America (AAFA) Editorial Board

© Asthma and Allergy Foundation of America
www.aafa.org 1-800-7-ASTHMA