Medical treatment for asthma and its side effects
A few years agoAsthma treatmentinvolved medications likeTheophyllineand Aminophylline, which helped to relax the bronchial passages. However, two decades ago it was discovered that inflammation and swelling of the airways are the main causes of this disease. Thus, the cornerstone of asthma treatment has been the prescription of anti-inflammatory medications, such as corticosteroids. Since asthma patients often need long-term medication, corticosteroids with minimal systemic absorption and serious side effects should be preferred.
Therefore, except in specific cases where a physician prescribes oral or injectable corticosteroids for short-term use during an attack, patients should never use oral or injectable corticosteroids continuously or periodically without a doctor’s guidance.
For this reason, prescribing inhaled corticosteroids, which are largely non-absorptive and have the least side effects at standard doses, with or without long-acting bronchodilators, is recommended.
What medications are used to treat asthma?
The medication dose is important
One of the most crucial points for asthma patients is that even when their symptoms lessen or stop with medication, they must never reduce their doses or stop using prescribed inhalers without consulting their doctor. It is advisable to let the physician make decisions regarding dose adjustments in appropriate situations during periodic visits, aided by logical questions and, if necessary, repeated spirometry tests.
Medications used to treat asthma are divided into two categories:
- Quick-relief medications
- Long-term asthma control medications
These medications, usually taken daily, are crucial for managing asthma. They help maintain asthma control and reduce the likelihood of asthma attacks.
Asthma control medications
Types of long-term asthma control medications include:
Inhaled corticosteroids:
These anti-inflammatory medications include Fluticasone (Flovent HFA), Budesonide (Pulmicort Flexhaler), Flunisolide (Aerobid), Ciclesonide (Alvesco), Beclomethasone (Qvar), and Mometasone (Asmanex).
You may need to use these medications for a few days to weeks to see their maximum beneficial effects. Unlike oral corticosteroids, these inhaled corticosteroids have relatively fewer side effects and are usually safe for long-term use.
Leukotriene inhibitors:
These oral medications include Montelukast (Singulair), Zafirlukast (Accolate), and Zileuton (Zyflo), helping to alleviate asthma symptoms within 24 hours. In some patients, these medications may cause mental symptoms including irritability, agitation, hallucinations,depressionand thoughtsof suicideshould be monitored. If you experience any unusual reactions while taking these medications, follow medical advice.
Asthma reliever medication
Complete list of asthma medications
Long-acting beta-agonists:
These inhaled medications, including Salmeterol (Serevent) and Formoterol (Foradil and Perforomist), help open the airways. Some studies suggest that these medications may increase the risk of asthma attacks and should, therefore, only be used alongside inhaled corticosteroids.
Additionally, since these medications may obscure worsening asthma conditions, they should not be used during severe asthma attacks.
Combination inhalers:
These medications, such as Fluticasone-Salmeterol (Advair Diskus), Budesonide-Formoterol (Symbicort), and Mometasone-Formoterol (Dulera), contain a long-acting beta-agonist paired with a corticosteroid. Because these combination inhalers include long-acting beta-agonists, they may increase the risk of severe asthma attacks.
Theophylline:
Theophylline (Theo-24, Elixophyllin, etc.) is a daily pill that helps keep the airways open by relaxing the muscles surrounding the airways (it is a bronchodilator).
Unlike in the past, this medication is not widely used for treating asthma patients anymore.
Keeping the airways open withasthma medication
Types of quick-relief asthma inhalers include:
These medications are used for quickly reducing symptoms during asthma attacks or as directed by a doctor before exercising.
Short-acting beta-agonists:
These fast-acting inhaled bronchodilators work within minutes to quickly relieve asthma attack symptoms. They include Albuterol (ProAir HFA, Ventolin HFA, etc.), Levalbuterol (Xopenex), and Pirbuterol (Maxair).
Short-acting beta-agonists can be inhaled or used with a nebulizer (a machine that turns asthma medications into fine mist-like particles).
Ipratropium (Atrovent):
Ipratropium works quickly, relaxing airway muscles and making breathing easier. It is mainly used to treat emphysema andchronic bronchitisbut may also be used occasionally during asthma attacks.
Preventive asthma medication
What medications can treat asthma?
Oral or intravenous corticosteroids:
These medications, including Prednisone and Methylprednisolone, reduce inflammation in the airways associated with severe asthma. They can cause side effects with long-term use and are therefore used only for short-term management of acute asthma symptoms.
If you experience asthma attacks, quick-relief inhalers can rapidly alleviate your symptoms. However, if your long-term asthma control medication works well, you shouldn’t need to rely heavily on quick-relief inhalers.
Keep track of your breathing throughout the week:
If your usage of quick-relief inhalers exceeds what your doctor has recommended, consult your physician. You might need adjustments to your long-term control medication dosage.
Asthma medication dosage
Allergy medicationsfor asthma controlAllergy medications can be helpful when asthma is triggered or worsened by allergies. These include:
Allergy injections (immunotherapy):
Allergy shots gradually reduce your immune response to specific allergens, typically administered weekly for several months, then once a month for 3 to 5 years.
Omalizumab (Xolair):
This medication is injected every 2 to 4 weeks for individuals with severe allergies and asthma. It works by altering the immune system’s response.
Allergy medications:
This category includes nasal sprays,
antihistaminesand decongestants, such as corticosteroids and cromolyn nasal sprays.Asthma and allergy medications
We’ll introduce some common asthma sprays and their side effects.
Types of reliever sprays for asthma
Salbutamol spray (Salbutamol)
Salbutamol spray is one of the most commonly used and fast-acting reliever sprays for alleviating asthma symptoms and attacks. It helps to relax the airways and alleviates symptoms like
coughingor feelings ofshortness of breath.Salbutamol is also available in tablet and syrup forms. This spray is typically blue in color and can be found in pharmacies. It is produced by various companies under different trademarks like Ventolin, Ventalex (Sina Darou Co.), or Salbutrex (Jaber Ibn Hayyan Pharmaceutical Company).
Salmeterol spray (Salmeterol)
This spray contains Salmeterol. Salmeterol is a long-acting bronchodilator and is not suitable for managing effects during an acute asthma attack. Its effects typically begin 10 to 20 minutes after use and can last up to 12 hours.
Usually green in color, the Salmeterol spray is available under various trademarks like Salmex (Sina Darou) or Serevent (GSK France).
Asthma medication and treatment with inhalers
Medical treatment for asthma and its side effects
Formoterol inhaler (Formoterol)
Formoterol is usually available as a spray or powder capsule. It is used to prevent complications from asthma attacks and airway constriction. This medication is a long-acting bronchodilator.
Formoterol is not suitable for managing acute asthma attacks! It is available in various forms, including sprays, capsules, and powder inhalers.
Some commercial products include Foradil inhalation capsules (Novartis Switzerland), Fomotizox powder or spray (Jaber Ibn Hayyan Pharmacy), and Oxis turbuhaler powder (Astrazeneca Sweden).
Types of asthma drugs and anti-asthma sprays
Mechanism of asthma medication action
Sodium cromoglycate (Cromolyn Sodium) inhaler or spray
Cromolyn sodium inhaler or spray is often used to prevent asthma-related complications by acting as a bronchodilator. Since its effects manifest more slowly than those of rapid-acting medications, Cromolyn sodium is not appropriate during acute asthma attacks!
Cromolyn sodium inhalers or sprays are available under various commercial names, including Cormolax (Sina Darou), Rhinomax nasal spray (Jaber Ibn Hayyan pharmaceutical), Nazocrom nasal spray (Sina Darou), or Cromal inhalation capsules (CIPLA India).
Beclomethasone spray (Beclometasone)
Beclomethasone sprays are steroidal (anti-inflammatory) medications designed to prevent asthma symptoms and attacks. Beclomethasone can reduce inflammation in the bronchi and airways, thus alleviating feelings of shortness of breath and mucus secretion in the respiratory tract.
Beclomethasone sprays are available under various trademarks and come in both inhalation and nasal spray forms, including Beclax (Sina Darou), Beclotrox (Jaber Ibn Hayyan Pharmaceutical), Bekoniz (GSK Spain), Beclonasal (ORION Finland), or Beclomet Aqua nasal spray (CIPLA India).
What is the best asthma medication?
Types of asthma medications and how they work
Fluticasone spray (Fluticasone)
Fluticasone is available as an inhaler or nasal spray and is one of the steroid sprays used to prevent asthma flare-ups or allergic rhinitis symptoms. Like other anti-inflammatory and steroid medications, Fluticasone helps reduce inflammation in the airways and lungs by inhibiting immune system cell activity.
Commercial names for this spray include Flutizox (Jaber Ibn Hayyan), Flazon (Raha Pharmaceutical), Fluzinos (Sina Darou), Fluksyne (GSK Spain), Fluksyte (GSK France), Apo-Fluticasone (APOTEX Canada), and Flumist (CIPLA India).
Budesonide spray (Budesonide)
Budesonide sprays are used to control chronic asthma and relieve allergic rhinitis symptoms. Like Beclomethasone and Fluticasone, Budesonide is a steroid and anti-inflammatory medication.
Commercial names include Budesonide Jaber spray (Jaber Ibn Hayyan Pharmaceutical), Budy Air (CHIESI Italy), Nebul Pulmicort (ASTRAZENECA Sweden), or Budecort (CIPLA India).
How asthma medication works
Asthma medication and special inhalers for asthma
Mometasone spray (Mometasone)
Mometasone (or Mometasone Furoate) in these inhalers has anti-inflammatory properties and is used to control and prevent asthma symptoms or allergic rhinitis. This steroid may also be used as an ointment for some inflammatory skin disorders.
Commercial names for Mometasone products include Nasonex (SCHERING PLOUGH Belgium), Ristanex (Sina Darou), Momenix (Jaber Ibn Hayyan Pharmaceutical), or Asmanex powder inhaler (MSD Belgium).
Montelukast asthma medication
Montelukast is used for asthma, exercise-induced bronchospasm, allergic rhinitis, primary dysmenorrhea, and
urticariaIt is mainly used as an adjunct treatment in adults alongside inhaled corticosteroids in situations where they alone are ineffective. It is also used to prevent allergic reactions.Side effects of Montelukast sodium
Weakness, dizziness, fatigue, fever and
headachesas well as nasal congestion, stomach pain, indigestion, gastroenteritis, coughing, flu, skin rashes, tooth pain, trauma.How asthma medication influences health
Theophylline medication for asthma
Theophylline is a bronchodilator used for treating asthma, emphysema, and bronchitis. It works primarily by relaxing the muscles surrounding the airways, thus facilitating airflow and improving breathing in cases of reversible airway obstruction.
Side effects of Theophylline
Headaches, restlessness, irritability, sleep disturbances, stomach discomfort, diarrhea, vomiting,
rapid or irregular heartbeat, skin rashes, andseizuresWhat are the side effects of asthma medication?Prednisolone for asthma
Prednisolone has anti-inflammatory properties and suppresses the immune system. It helps to reduce swelling, redness, itching, and allergic reactions. It is also used to treat various conditions such as nephrotic syndrome, asthma, arthritis, skin issues, and severe allergies. This medication should be taken after meals. While using it, sodium intake should be minimized, and
potassium
should be increased.Side effects of PrednisoloneGastrointestinal side effects, skin rashes,
osteoporosis
, increasedblood pressure, allergic reactions, local or systemic infections, Cushing’s syndrome, edema, tissue atrophy, injection site irritation or rash, inflammation, and delayed wound healing, nausea,weight gainrapidly and menstrual disorders in women, stomach painAsthma treatmentDefinitive asthma treatment
