Dr. Donald Levy, Allergy, Asthma, and Immunology, Orange County Ca


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Office Location
:
705 W. La Veta Ave.
Suite 101
Orange, CA 92868
(714) 639-7847

 


New Approaches to Treating Asthma: What Medications Are
Used to Treat Asthma?

There are two basic kinds of asthma medications:
  • Rescue (reliever) medications: Rescue medications, also called reliever medications, act quickly to relieve asthma symptoms by relaxing muscles that have tightened around the airways. Rescue medications are short-acting bronchodilators that include inhaled beta2-agonists (such as albuterol) and anticholinergics (such as ipratropium). For severe episodes, a doctor also may prescribe a short course of an oral corticosteroid medication (such as prednisone). Although corticosteroids are not bronchodilators, they can help relieve acute asthma symptoms quickly, within a few hours to a couple of days.
  • Controller medications: Controller medications are taken every day to control asthma and help prevent attacks. These drugs can prevent, reduce or reverse the swelling in the airways that causes asthma symptoms. Controller medications include anti-inflammatory drugs such as inhaled cromolyn and nedocromil, inhaled corticosteroids, oral corticosteroids and oral leukotriene inhibitors. Other types of controller medications include long-acting bronchodilators that are used together with the anti-inflammatory medications. The most commonly used long-acting bronchodilators are long-acting inhaled salmeterol, formoterol and oral sustained-release theophylline. A newer disk-shaped inhaler is now available that combines the corticosteroid fluticasone with the bronchodilator salmeterol.
How Are Asthma Medications Prescribed?

Each person's asthma is unique. For example, each person's airways react to specific triggers at specific times and each person's symptoms are different. Also, people respond to different asthma medications in different ways. As a result, asthma medications must be tailored to each person's needs. It's essential for people with asthma to work closely with their doctor to find the medications that work best for them.

What Is an Asthma Management Plan?

An asthma management plan tells you what asthma medicine to take and when to take it. It will help you take your medications correctly.

  • Rescue medications: If you have symptoms only every now and then (less than once or twice a month), a short-acting inhaled bronchodilator may be all you need to control your asthma symptoms. If you have an asthma episode, your physician may tell you to take more of your bronchodilator medication, which may be enough to relieve your symptoms. However, a second medication may be prescribed for severe attacks. Your asthma action plan will give you detailed information on what medications to take during asthma attacks and how to take them.

    If exercise is one of your asthma triggers, your physician may prescribe an inhaled short-acting bronchodilator to take before you exercise to prevent an exercise-induced asthma attack.

    REMEMBER: It is very important to understand that an increase in the number of asthma attacks, or an overall increase in the frequency or severity of your asthma symptoms, is an indication that your current medications are not adequately controlling your asthma. Tell your doctor immediately about any changes in your asthma symptoms.

  • Controller medications: Your physician will prescribe one or more anti-inflammatory medications to reverse and prevent the swelling that causes the symptoms of asthma. If you have symptoms more than once or twice a week, you need an anti-inflammatory controller medication. You need to take this medication EVERY DAY, even on days when you don't have symptoms. If you have allergies, your doctor also may prescribe an extra dose of the anti-inflammatory drug cromolyn to take when you know you will be exposed to a known trigger. For example, if you are allergic to cats, you would take a dose of cromolyn before visiting the house of a friend or relative who has a cat.

    For some people, a single controller medication may not be sufficient to control asthma symptoms completely. Your doctor may ask you to take an additional controller medicine. Newer inhalers combine the corticosteroid fluticasone with the bronchodilator salmeterol to treat both airway inflammation and airway constriction.

    REMEMBER: If your asthma management plan is not working and you still have symptoms with exercise, at rest, at night or early in the morning, you need to review your asthma management plan with your doctor. Before changing your medications, your doctor will evaluate your trigger-control measures, your technique of administering your inhaled medications, and the severity of your asthma, and try to identify any problems you may have taking your medications.

Are Asthma Medications Safe?

All medications have the potential for side effects but, if asthma medications are taken as directed, their side effects should be minimal or, if they occur, can be managed. Some people are afraid that they will become addicted to their asthma medications but, in reality, asthma medications are not addicting. Other people may worry that if they take a medication regularly it will stop working, but this is not the case with asthma medications.

If you are pregnant, you may be especially concerned about the effects of asthma medications on the fetus. All asthma medications have been used extensively over many years by pregnant women with asthma. Each medicine has been demonstrated to be safe to take during pregnancy, and you can take these medicines without worry. Keep in mind that the risk to your baby is much greater if your asthma is not under control. Talk to your doctor about any concerns you may have.

What to Do If Side Effects Occur

  • Report all side effects to your doctor immediately.
  • Do not stop taking the medication completely until you talk to your doctor. Stopping the medication could cause your asthma to get worse.
  • If the side effects are from an inhaler medication, a change in your inhaler technique may correct the problem. Alternately, your doctor may recommend changing the way you use your medication, or he or she may prescribe a different asthma medication.
Excerpted from Understanding Asthma Health Management Bulletin: Information for asthma patients and their friends

Medical Writer: Claudia Morain, Davis, Calif.Your Doctor

Last Updated: February 2005 by Steven R. White, M.D., Associate Professor of Medicine, University of Chicago, Pulmonary and Critical Care Medicine
© Original Copyright 1997 American Medical Association. Updated February 2005.
 


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