Asthma Medications Basics

There are two different groups of medicines commonly used to treat asthma: Rescue medications, which are short-acting bronchodilators used to treat acute symptoms, and Controller medications, either anti-inflammatories or long-acting bronchodilators, used to control asthma and prevent symptoms.

Rescue medications short acting bronchodilators

These medicines relax the tightened muscles around the airways to help open them up and relieve the acute symptoms of an asthma attack such as coughing, wheezing, shortness of breath and difficulty in breathing. If you need these medications more than 1-2 times a week your asthma is NOT well controlled and you may need to start (or increase your use of) anti-inflammatory medications.

Short-acting bronchodilators (Albuterol, Proventil, Ventolin, Alupent, Maxair; or Xopenex) are the main treatment for acute asthma attacks and act within minutes to relax tightened airways.

Side effects: rapid heart beat, tremors, insomnia, anxiety

Anticholinergics (Atrovent) are inhaled bronchodilators that are sometimes used along with albuterol to treat acute attacks. Combivent is an inhaler containing both albuterol and atrovent.

Side effects: dry mouth

Controller medications include both anti-inflammatories (steroids and leukotriene modifiers) and long-acting bronchodilators. These medications are taken every day to control your asthma and prevent or lessen asthma attacks, and are generally used for patients having symptoms more than once or twice a week. Do not stop these medications without consulting your physician. There are several different types of controller medications.

Corticosteroids (or steroids) - These medicines help reduce swelling and inflammation, making the airways less likely to react to triggers and decreasing the amount of mucous secretion. These steroids are not related to the anabolic steroids sometimes misused by athletes to increase performance. Available in inhaled (safer) or oral forms.

Inhaled corticosteroids (Flovent, Pulmicort, Beclovent, Vanceril, Azmacort, Aerobid) are used every day to prevent asthma attacks and should not be stopped without notifying your physician. Advair is a combination of an inhaled steroid (Flovent) plus a long-acting bronchodilator (Serevent).

Side effects: Some people may experience hoarseness or a yeast infection in the mouth (thrush). For this reason it is very important to use a spacer when taking an inhaled steroid and to rinse your mouth with water after use. Use of very high doses for long periods of time may be associated with slowing of growth in children and thinning of bones (osteoporosis). Such high doses, though, are only required for patients with severe asthma.

Oral Steroids (Prednisone, Prednisilone, Prelone, Pediapred) are powerful anti-inflammatories. These are only used for patients with severe asthma attacks.

Side effects: Taking oral steroids for a long period of time or in high doses can cause many more side effects than inhaled steroids, and are associated with an increased risk of growth suppression and osteoporosis. One of the goals of asthma treatment is to minimize your need for use of oral steroids.

Leukotriene modifiers (Accolate, Singulair) also control asthma by reducing inflammation but are not steroids. They typically do not work as well as the inhaled steroids, and are generally only used if there are problems with the use of the inhaled steroids.

Side effects: rare headache, stomach upset.

Long acting bronchodilators (Serevent, Foradil,Volmax) do not reduce inflammation but help to control asthma by opening airways for long periods of time (8-12 hrs). Unlike the short acting bronchodilators, these drugs are used routinely to control asthma and should NOT be used to treat acute asthma symptoms or an asthma attack.

Side effects: rapid heart rate, tremor, insomnia, anxiety.