Asthma Medication

Asthma Medication

• History of asthma treatment goes back to thousands of years
• The most important advances in modern medicine have been made during the last 75 years
• The medication prescribed depends on the severity of their illness and the frequency of their symptoms.
• Broadly classified as relievers [mostly bronchodilators], maintenance/preventers [mostly anti-inflammatories], and emergency treatment.
• Variety of inhaled and oral medications used today
• Either treat the bronchoconstriction or inflammation that causes asthma and its symptoms
• Bronchodilators - dilates (enlarges) the bronchi (airway) in the lungs and relaxes the tiny muscles that wrap around and squeeze the bronchi, therefore allowing the airway to open up again.
• Anti-inflammatory medication - decreases the inflammation, soreness, and swelling within the airway, therefore increasing the space within the airway
• National Institute of Health (NIH) recommends a "step-down, step-up" approach to asthma management means that when you are first evaluated, you may be given a dosage high enough to quickly bring your symptoms under control. Then, as your doctor monitors you with follow-up visits, your dosage may be lowered until you are taking the least amount of drug required to keep you symptom-free. If the dose is lowered too far, your doctor will "step up" the dose back to a level needed for adequate control. This step-down, step-up strategy is not needed or appropriate for all patients.

Reliever Medications

• Designed to treat wheezing, coughing or chest tightness during an attack
• Work very fast to control asthma symptoms
• Also referred to as rescue or quick-relief medication
• Used on an "as needed" basis to "rescue" your patient from active symptoms.

The following are the main drugs in this category.

• Bronchodilators
• Oral steroids
• Long-acting bronchodilators
• Theophylline

Maintenance or Preventative Medications

• Used to prevent an asthma attack or symptoms from even starting
• Main goal is to prevent symptoms from occurring in the first place or according to modern medicine they "maintain" a symptom-free state”
• Taken daily whether the patient is sick or well
• In general, anyone with persistent asthma should take a control drug every day
• Some people use control drugs only during times when they are likely to be exposed to one of their asthma triggers, i.e. particular season or when staying at a pet owner's house
• Mainly treat inflammation, not bronchoconstriction.
• Do not work to immediately open up the individual’s airway during an attack

The following are the main drugs in this category.

• Inhaled steroids
• Long-acting beta-agonists
• Leukotriene modifiers
• Theophylline
• Nedocromil and cromolyn
• Combination therapy

There are three main goals of maintenance therapy:

1. Keep the patient in a symptom-free state on a daily basis.
2. Decrease the frequency and severity of attacks. Adequate maintenance therapy should prevent attacks from even occurring in the first place. When they do occur, they should be milder.
3. Decrease reliance on albuterol. If used continuously for many months or years, an individual may become resistant to it. It is important not to let this happen since albuterol is one of the only bronchdilators available to us. However, modern medical doctors say patients should not be afraid to use albuterol as it takes several months to years of daily use to become resistant to it, and resistance is rare anyway. Most people use it frequently for years and have no problems with resistance. It is preferable to be on one of the maintenance medications daily than to use albuterol daily.