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An Informative guide for Asthma Medications

An Informative guide for Asthma Medications

Introduction

“Asthma is an inflammatory disease of the airways to the lungs.” This results in difficulty in breathing and also it becomes difficult or not possible to perform certain types of physical work.

At an average around 27 million Americans suffer from Asthma as per the Centers for Disease Control and Prevention (CDC). It is a long-term issue among “American Children.” Out of every 12, 1 child suffers from Asthma. As and when you breathe, the air travels from “your nose” to the throat, inside the airways and finally goes to the lungs. In the lungs of an individual, there are various tiny “air passages” that delivers oxygen into the blood-stream via air.

The symptoms for asthma show up when there is swelling in the lining of the airways and there is tightening of the muscles. There is a reduction in the passage of air, also due to airways being filled up by mucus.

This situation would result in asthma “attack”, majorly cough and tight feeling in the chest.

The symptoms for Asthma includes the following:

  • Cough i.e. majorly at night either during work-out or while laughing.
  • Wheezing i.e. while breathing a sound is heard.
  • Chest gets tight
  • Breathlessness
  • Tiredness
  • Shortness of breath

The initial step to treat the symptoms for asthma would eliminate your triggers causing asthma. But along with this, even medicines would be required to prevent and for the treatment of asthma symptoms.

Depending on various factors such as age, symptoms, triggers, and reactions to the medicines, the correct type of drugs are recommended.

Medicines for asthma which are effectual and even those approved by the American Lung Association are not readily got over the counter (OTC). OTC drugs for asthma are not preferred. The doctors are the best guidance for medications.

Inhalers and Nebulizers

Medicines for asthma occur in many kinds i.e. pill, liquids, injections or inhalers. Few of the medicines are available in the form of sprays or powders which requires inhalation inside the lungs. The medicines for asthma could be taken in the form of an inhaler or a nebulizer. Both of these provide long and rapid-acting drugs. The effect of the medicines would not get modified if that device is used. There are various positives and negatives of every method, in this case, personal choice matters.

Inhalers

These are “devices” used to force or push drugs inside the lungs. For the usage of this device, support from the “users end”, as there is a requirement of the pressing the apparatus and then the medication would be inhaled.

Inhalers are movable i.e. portable, tiny and not heavy, but this also depicts that they could be easily be lost. Important to have an alternative, if there is the usage of an inhaler.

There are two types of Inhalers: metered-dose inhaler (MDI) and dry powder inhaler (DPI).

When an inhaler is pressed, the MDI produces a “measured” flow of the drug. You could also keep a check on the count of the dosages, to know when the drug is about to get over. For easy use, a spacer could be used with an “MDI inhaler.” The inhaler is connected to the spacer and “holds” the drug in a tiny room, so once ready it could be inhaled. This is easy to be used for small children. For an effortless inhalation, a mouth-piece or a face-mask could be connected to the spacer.

Nebulizers

These are devices which work on batteries or plugs that convert the liquid drugs for asthma into a mist i.e. kind of vapors, which becomes “easy” for inhalation. Since they are automated, they are kids-friendly. To inhale the asthma medicine, either you “wear nebulizer’s mouth-piece or face-mask, then take in the mist i.e. vapors gradually. The duration to take in the medicine takes approximately 5 to 10 minutes via the nebulizer. The draw-back of this device is that it is not easily movable or portable and also it requires a source of power. They could be big or large and causes too much sound.

Bronchodilators and Anti-inflammatory Drugs or Medicines

Medicines for asthma are divided into two sections such as bronchodilators and anti-inflammatories. They work by focusing majorly on two symptoms of asthma.

The bronchodilators focus on muscles that are tightened in the lungs and are affecting or hampering the airways. This class of medicines helps in the relaxation of the muscles of the lungs. This helps in increasing the width of the airways and helps in easy breathing. These are rapid ways to get ease or relief from symptoms of asthma.

Anti-inflammatory agents focus majorly on lung inflammation. They decrease the swelling and irritation caused in the lungs, which makes breathing easy. These drugs are helpful in “maintenance” for the prevention of asthma symptoms.

Quick-relief medicines or drugs

Asthma medicines are categorized as “quick-relief” and “long-term” drugs or medicines. “Quick-relief” medicines or drugs are also termed as “rescue therapy.” They help in quick relief from the outburst of asthma or more dangerous attacks.

Short-acting beta antagonists

At the time of attack caused by asthma, the drugs which are inhaled give immediate relief from the symptoms and this relief would go on for a few hours. These drugs are used for treating attacks caused by exercise. For example:

Albuterol (ProAir HFA, Ventolin HFA) and Levalbuterol ( Xopenex HFA)

Side-effects of these medicines are Trembling, anxiety, pain in the head, irritation of the throat, heart rate gets rapid and more.

Very rarely these medicines result in arrhythmias or dysrhythmias of the heart.

Anticholinergics

These are drugs belonging to the rapid-acting bronchodilators that can be inhaled. They provide instant relief from the attack caused by asthma. For example ipratropium bromide (Atrovent HFA).

Side-effects include breathlessness, bleeding from the nose, Dryness of the nose, irritation to the nose, mouth becomes dry.

Rarely the side-effects that would occur are bronchospasms i.e. spasms of muscles in the lungs which restrict the airways. Rarely also would result in the “worsening of the pre-existing heart arrhythmias or dysrhythmias.”

Asthma control drugs that are on a long-term basis

These drugs are taken regularly. Rather than treating the attack caused by asthma, they are used to prevent the symptoms caused by asthma. On a long-term basis, the physician might recommend an anti-inflammatory medicine or a bronchodilator medicine or drugs.

Medicines are categorized as below:

Inhalable Corticosteroids

These belong to the anti-inflammatory category. They are very powerful and “commonly” recommended medicine for asthma. For example beclomethasone (QVAR), budesonide (Pulmicort Flexhaler), flunisolide (Aerospan), fluticasone (Flovent Diskus. Flovent HFA), mometasone (Asmanex).

Side-effects of these drugs are an irritation to the throat, bleeding from the nose, pain in the head and irritation to the nose.

Some of the rarely occurring side-effects would include bronchospasms (constriction of the muscles in the walls of the bronchioles), problems in vision, blood pressure increases in the eyes, growth of children are affected.

Oral Corticosteroids

These medicines affect the body entirely. They help in the treatment of critical or acute symptoms of asthma. They belong to the anti-inflammatory category of medicines. They help in the relief from “swelling and inflammation in the airways.” These medicines are taken via “mouth.” For example prednisone, methylprednisone, hydrocortisone.

Side-effects of these medicines include an increase in weight, blood glucose levels increase, problems in sleeping, healing of wounds takes time or goes slow.

See Also

There could side-effects which are serious or risky if the use of corticosteroids is on a long-term basis. Hence, these medicines should be made use of on a short-term basis. Examples of side-effects that are harmful or dangerous are peptic ulcers, osteoporosis (bone disease, bones get weak and brittle), glucose intolerance and gaining of weight.

Long-Acting Beta Agonists (LABA)

These are termed as bronchodilators. They are used to avoid attacks caused by asthma. These are taken two times every-day via an inhaler. They are used always taken into consideration along with an “inhalable corticosteroid.” These drugs are rapid-acting and they provide ease for the next 12 hours. Examples of the medicines include formoterol (perforomist), salmetrol (serevent diskus). Very common side-effects of this medicine include pain in the head and muscles. Harmful side-effects would consist of bronchospasm and spasm of the throat.

Combination Inhalers

These are commonly recommended for the treatment of asthma. The combination consists of corticosteroids and LABA. In the United States (US) the combinations are as mentioned below:

Budesonide and formoterol (Symbicort)

Fluticasone and salmeterol (Advair Diskus)

Commonly occurring side-effects are a pain in the head and infection of the throat. Harmful side-effects which occur very rarely are arrhythmias or dysrhythmias of the heart, hypertension, and bronchospasms.

Leukotriene Modifiers

These are anti-inflammatory drugs. The way they work is quite different than the corticosteroids. They are available in a pill form. The action of this pill is to stop the functioning of leukotrienes. These are products that are found in the lungs that constrict the way of air passage. They also result in the lungs making extra mucous.

For example montelukast (Singulair, zafirlukast (Accolate), Zileuton (Zyflo, Zyflo CR)

Some of the side-effects include pain in the head, stomach, and muscles. Some of the severe side-effects include damage to the liver, disorders in the blood and seizures (immediate, uncontrolled electrical disturbance that occurs in the brain).

Methylxanthines

This medicine belongs to the bronchodilator category but is also considered to have some effects on an anti-inflammatory. These medicines are in the form of pills. For example Theochron, Theo-24, Elixophyllin. These medicines are not very commonly recommended. These medicines need constant observation or watch to see to it that the medicines remain in the body “within a narrow range.” If the quantity goes beyond the recommended range, it would result in side-effects like arrhythmias or dysrhythmias of the heart and seizures.

Common side-effects are a pain in the head, problem in sleeping, nausea, and vomiting.

Immunomodulators

These drugs or medicines are termed as biologics. These affect the “immune system”, by clogging the products that result in an attack of the asthma. These drugs are only recommended for individuals who are not able to stop the symptoms of asthma with other medicines for asthma. For example mepolizumab (Nucala), Omalizumab (Xolair), Reslizumab (Cinqair).

The various side-effects caused by this category of drugs are a pain in the head, fatigue, and reaction of the injection sites, pain in the muscles and joints, infections. Some of the harmful symptoms include “hypersensitivity reaction”, which consists of anaphylaxis (serious life-threatening reaction to the allergies, heart attack, and stroke.

Asthma Medicines

As mentioned above, some drugs are taken in by making use of a metered-dose inhaler, inhaler for dry powder or a nebulizer (they convert liquid to mist i.e. vapors. Other medications are taken by mouth i.e. orally, pill or tablet and liquid form. Also could be given by using injections. Few of the medicines for asthma are taken together.” For the rapid usage of the drugs to your airways, which is possible to get in the medicines to your airways.

For how long are the asthma medicines to be taken for?

There are no ways to cure asthma. How frequently the medications are to be consumed is dependent on the severity of the condition, how often the symptoms occur. For example: if post-exercise or during exercise there is trouble, it might be treated with an inhaler “before work-out.” While many of the individuals require drugs or medicines used for treatment daily.

Asthma Medications guidelines

  • Important to always keep the drugs for asthma available.
  • Important to follow the plan of treatment and action.
  • Do wash and clean the hands before taking the drugs for asthma into consideration.
  • Go slow. Check every medicine carefully before consuming it.
  • As per the mentioned instructions, store the drugs.
  • Keep a regular check on the liquid medicines. If any changes observed in the liquid form of the drugs, just throw it away.
  • Inform the physician about the other drugs or medicines you consume.

Conclusion

There are various forms of choices used for the treatment of symptoms of asthma. Important to know things like kind of drugs taken by the individual, how to take the drug, certain factors such as age, how severe the symptoms are, “triggers ” and lifestyle of the individual.

Important to be aware of all the latest and useful medicines, which will ultimately help you treat and prevent asthma. Important to have a constant conversation with your physician about the symptoms and the role of medicine in an individual’s life. They would provide a plan of action or treatment keeping these things or issues into consideration.

References

  1. https://www.ncbi.nlm.nih.gov/books/NBK531455/
  2. http://www.lungindia.com/article.asp?issn=0970-2113;year=2015;volume=32;issue=7;spage=3;epage=42;aulast=Agarwal
  3. https://www.frontiersin.org/articles/10.3389/fped.2018.00234/full
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