Type of asthma medications

There are 3 main types of asthma medications:

• Preventers.
• Relievers.
• Controllers.

Asthma medications are not addictive.

1. Preventer Medications

   These medicines work by :

   • Reducing inflammation or swelling of the airways.
   • Reducing mucous production.
   • Making the airway less sensitive to triggers and irritants.
   • Preventing the occurrence of asthma symptoms and attacks.

   They need to be taken everyday and on long-term basis regardless of the symptoms. They do not provide immediate relief of symptoms.

   There are 2 groups of preventers:

   Examples of inhaled steroids include:

    
   Steroid Inhaler 

   • Inhaled Steroids.
     • Powder form.
     • Aerosol.
       • Beclomethasone (Becotide).
       • Budesonide (Pulmicort, Inflammide).
       • Fluticasone proprionate (Flixotide).
       • Ciclesonide.
   • Non-steroidal drugs. ie Leukotriene receptor antagonist.
     • Montelukast or Singulair is the latest asthma drug available.
     • As oral tablets and granules.

2. Reliever Medications

   • These medications work by:
     • Relaxing the smooth muscle around the airways.
     • Opening the airways.
     • Providing immediate relief from asthma symptoms.
   • They are first aid treatment for asthma attacks and can be used before exercise to prevent exercise-induced asthma. They do not modify the underlying inflammation.
   • These medicines are taken only as and when necessary to provide quick relief of asthma symptoms.
   • The patient must carry the medicine with him at all times.

   There are 2 types of relievers:

   Short-acting beta agonist

   
   Inhaler

   • Available in inhaled or oral forms
     • Salbutamol (ventolin) and Terbutaline (Bricanyl).
     • Onset of action within 10-15 minutes and their effects last 4-6 hours.
   • Anti-cholinergics
     • The main agent currently available is Ipratropium bromide (atrovent).
     • Sometimes used in combination with the short-acting Beta-agonist (Berodual).

3. Controller Medications

   These medicines also known as Long-acting Beta2-agonists. They act to relax the muscles of the airways and work over a long period of time by keeping the airways open. They have a slow onset of action but their effects are maintained more than 12 hours. These are normally used in moderate to severe asthma and must be used in combination with inhaled steroid. They need to be taken daily as prescribed by the doctor. Some examples of controllers are:

   • Salmeterol (Serevent).
   • Formoterol (Oxis).

   At present long-acting beta2-agonist have become commercially available combined with inhaled steroids in a single device such as Seretide accuhaler and evohaler (Fluticasone and Serevent) and Symbicort Turbuhaler (Budesonide and Formoterol).

   Other Medicines

   • Anti-histamines can be used with asthma medications to treat other associated allergic diseases.
   • Antibiotics are rarely necessary as infections are mostly caused by viruses.
   • Cough mixtures are not useful in asthma management.
   • Tranquilisers are dangerous as they may suppress the breathing process.
   • Desensitisation is not recommended.