Asthma Medications

Asthmatics have a wide range of medications at their disposal that can effectively control their symptoms, often within seconds. Asthma medications fall into a number of different drug groups each with varying mechanisms of action and side effects. Daily prevention of attacks and asthma treatments can be accomplished through the use of inhalers and bronchodilators.

Keep Current on Treatment Options

Advances in the range of asthma treatments are certainly encouraging. Most asthmatics, however, would prefer to avoid a lifetime of dependence upon medication at all! It makes sense, therefore, that prevention of triggers should be the first line of defense.

Knowledge of how to prevent or avoid asthma triggers is vital. If you are asthmatic, you should know

  • whether the severity of your attacks are stabilizing or deteriorating
  • whether your prescribed medication is the most appropriate for your needs
  • whether your condition might benefit from a different type of asthma treatment.

Classes of Asthma Medication

Asthma medications can be categorized into a few general drug groups. Members within each group are considered more or less interchangeable.

Bronchodilators (drugs that relax the muscles around the airways) are generally the most frequently used drugs for treatment. Bronchodilators can be inhaled, taken by mouth, or injected into the muscles or veins.

The following is a summary of common medications used in asthma treatment.

Drug group: Beta2 (ß2) adrenoreceptor agonists

(adrenoreceptor refers to a site where adrenalin works)

Common drugs: Common ß2 agonists include albuterol/salbutamol (Ventolin®, Proventil®), terbutaline (Bricanyl®), rimiterol (Pulmadil®) and fenoterol (Duovent®).

How they work: Adrenoreceptor agonists have the same effect as natural adrenalin: They help keep the airways open by relaxing the muscles in the walls of the airways. ß2 receptor agonists are normally inhaled and are used at irregular intervals and as a first line treatment.

Possible side effects: Although B2 agonists can be highly effective immediately (and for up to six hours) if taken in high dosage, they sometimes produce a “rebound” effect that can trigger an additional attack. Also, ß2 agonists have no effect on inflammation.

Drug group: Corticosteroids (steroid drugs)

Common drugs: Common corticosteroids include prednisolone (Prednesol®) and methylprednisolone (Medrone®).

How they work: Corticosteroids can be taken by mouth, inhaled, or injected. These drugs are highly effective in suppressing inflammation and reducing mucus secretion.

Possible side effects: Dosage must be monitored carefully by a physician. Some patients may experience suppression of the body’s production of natural steroids, growth suppression, the likelihood of new infections, high blood pressure, exacerbation of stomach or duodenal ulcers, osteoporosis, diabetes, glaucoma, cataracts, and increased growth of body hair.

Drug group: Anticholinergic drugs (ipratropium)

Common drugs: Common anticholinergic drugs include Atrovent®, Combivent® and Duoneb®.

How they work: Inhaled anticholinergic asthma drugs relax the airway muscles much like atropine (belladonna), but without the unpleasant side effects to the nervous system. If a ß2 is followed by ipratropium, the two drugs tend to enhance each other’s effects.

Possible side effects: Not always effective in preventing the narrowing of airways in exercise- and cold air-induced asthma.

Drug group: Xanthine derivatives

Common drugs: Common xanthine derivative bronchodilators include theophylline (e.g. Choledyl®, Theo-Dur®) and theobromine.

How they work: Theobromine has a similar (although lesser) effect to caffeine. Theophylline has a strong effect in widening the airways. Its main action is to relax the muscles in the bronchi and improve efficiency of the diaphragm.

Possible side effects: Excessive doses of theophylline have been known to cause convulsions and in rare cases, brain damage. It is not recommended for people who are prone to panic disorders. Other possible side effects include heart irregularity, personality changes, hyperactivity, nausea and vomiting.

Drug group: Leukotriene modifiers

Common drugs: Singulair® (montelukast), Zyflow® (zileuton) and Accolate® (zarfirlukast) are all leukotriene modifiers.

Leukotrienes are chemicals created during an asthma attack that cause the airways to constrict. Leukotriene modifiers block the action of leukotrienes on the airway. These drugs are typically used in long-term management of asthma, not to treat symptoms during an asthma attack. Use of leukotreiene modifiers may reduce the need for B2 agonists and inhaled corticosteroids.

Possible side effects: Montelukast is the least likely to cause side effects, such as the gastrointestinal upset caused by zarfurlukast and the rare, but potential liver damage caused by zileuton.

Drug group: Sodium cromoglycate drugs

Common drugs: Sodium cromoglycate is more commonly referred to as cromolyn (Intal®, Novo-cromolyn®).

How they work: Taken by inhalation in aerosol solution or as a powder driven by a turbo inhaler, cromolyn works by preventing the release of histamines into the airways. Sodium cromolglycates are particularly effective in the treatment of allergic asthma.

Possible side effects: Sodium cromoglycates should not be used during an attack as throat irritation, coughing and temporary spasm of the airway can occur following treatment.

Immunotherapy

Sometimes called multiple allergen immunotherapy or allergen desensitization therapy, immunotherapy is generally accepted by the medical profession as an effective and safe treatment for asthma in both children and adults. Studies to date, including those documented by the American College of Allergy, Asthma and Immunology, indicate that immunotherapy can be particularly effective in treating allergic asthma.

Resources

Healthscout.com. (nd). Asthma treatment. Health Encyclopedia — Diseases and Conditions.

National Heart, Lung and Blood Institute. (nd). How is asthma treated? NHLBI Diseases and Conditions Index.

National Jewish Medical and Research Center. (nd). Asthma treatments and asthma medications.

Rubins, J., Hale, K.L. (nd). Asthma. eMedicine.com.

PumonologyChannel.com. (nd). Asthma: Treatment.