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Asthma Medication Options
If you’ve been diagnosed with asthma, you’re probably facing a confusing array of treatment options. From inhalers and pills to liquids and injections, the decision can be intimidating, especially since everyone responds a bit differently to a given medication.
The good news is, with so many asthma medication options at your fingertips, there’s a very good chance you’ll find a combination that works well for you. Most patients will need both a long-term and short-term solution, and the dose and type of drug will likely need to be adjusted now and then.
Asthma is a chronic disease, so treatment is a long-term commitment. Monitoring your changing symptoms, reactions to medication, and how you handle asthma attacks will help your doctor fine-tune your medication until your asthma is under control and you can breathe comfortably every day.
Types of Asthma Medications
Ultimately, all asthma medications aim to improve airflow in and out of your lungs. However, different medications manage this in different ways. The dozens of specific asthma drugs can be broadly divided into two categories:
Anti-inflammatories
By reducing swelling and mucus within the airways, anti-inflammatory medication allows more air through, and reduces sensitivity so your airways are less likely to react to triggers. Since they are designed to prevent or control asthma symptoms, they are typically taken every day.
Bronchodilators
In contrast to anti-inflammatories, bronchodilators target the bands of muscle around the airways rather than the tissue on the inner walls. As the tight muscles relax, airways open up wide, breathing improves, and mucus can be coughed up more easily. Long-acting bronchodilators are used to control asthma, and the short-acting version is used to stop an attack.
Long-Term Asthma Medications
Prevention is the most important part of treatment: the daily medication you take to prevent symptoms and attacks is what keeps your quality of life high and your focus off your asthma. Long-term medication needs to be taken every day to have an impact, even when you don’t notice any asthma symptoms at all.
Inhaled Corticosteroids
Designed to reduce swelling and decrease mucus production, inhaled corticosteroids (taken through a plastic inhaler) are the go-to medication for persistent asthma symptoms. They are typically taken every day to keep the airways clear, and you may need to wait a week or longer for them to take effect. Inhaled corticosteroids come in the form of a dry powder or metered dose inhaler.
You may have heard that there are risks associated with corticosteroids, but rest assured, side effects are few when the medication comes in inhaler form. Since the drug is deposited right in the airway, very little is absorbed into the rest of the body, so the bones and tissues aren’t affected.
Long-Acting Beta Agonists (LABAs)
If your inhaled corticosteroid is not working well enough on its own, you may need to combine it with a long-lasting beta2-agonist for more comprehensive relief. While the inhaled corticosteroid reduces swelling and mucus, the beta agonist (a bronchodilator) will relax the rigid muscle around your airways to allow more air in and out of the lungs with every breath. LABAs are effective for more severe asthma, and to prevent nighttime symptoms.
Sometimes a long-acting beta agonist is prescribed to keep your corticosteroid dose down, if you or your doctor are concerned about side effects (high corticosteroid doses are more likely to cause throat soreness, thrush, bone thinning, and cataracts). However, LABAs are never used on their own, since they have been known to cause severe asthma attacks in some people.
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Theophylline
Another type of bronchodilator, Theophylline is taken in pill form every day to control mild but persistent asthma symptoms. Like LABAs, it relaxes the muscles around the airways, but it can also improve the lungs’ defenses against irritants. Dosage can be a bit tricky with Theophylline; since too much can bring about side effects, you will probably need regular blood tests to make sure you stay in the “safe” zone.
Allergy Shots
Allergic asthma is the most common form of the disease, and if your allergies are exceptionally bad, you may need allergy shots from time to time. These injections aim to reduce your body’s sensitivity to the allergens that cause you trouble, and you may need regularly scheduled immunizations to desensitize your body enough to find relief.
Allergy shots are a long-term management approach: you’ll get the shots weekly at first, then monthly for a few years. If your allergies are milder and seasonal, you may want to stick with oral and nasal spray antihistamines and decongestants to relieve the symptoms as they pop up. Corticosteroid sprays are available, as well.
Quick Relief Medications
Even if you do well with your day-to-day asthma management, there may be some instances where your symptoms get the better of you. Stress, exercise, allergens, and other environmental triggers can stir up a severe respiratory response, and you’ll need a fast-acting rescue medication to get your breathing back to normal.
Short-Acting Beta Agonists
Like their long-acting cousins, short-acting beta agonists work by relaxing tense muscles around the airways — but they act quickly and powerfully to quell an asthma attack. You’ll start to notice the effects within minutes, and they will last for up to four or five hours.
If you’re prone to exercise-induced asthma symptoms, you can take one or two puffs of a short-acting bronchodilator 15 minutes prior to exercise to keep symptoms at bay through your workout.
Oral and Intravenous Corticosteroids
Severe asthma attacks may call for a powerful anti-inflammatory rather than a bronchodilator. In these cases, corticosteroids can be administered in pill or IV form, for swift and wide-spread relief. However, since they are systemic medications (that is, they are absorbed into the bloodstream and carried through the body), they can cause more serious side effects if used too often.
Quick-acting rescue medicine is to be used just as the name describes — as a rescue device when symptoms are severe. If you’re using your short-term medication frequently, it’s a sign that your asthma is not under control, and you’ll need to revisit your long-term care plan. Too much quick-acting medication over a long period of time can bring a host of side effects.
Finding the Right Management Plan for You
Your specific set of circumstances – age, symptoms, medical history, and asthma severity – will determine which medications you should take. In most cases, two or more medications are used (at various times) to keep all your symptoms in check.
Before settling on an asthma medication regimen, your doctor will need to know a few details about your condition, like:
- How bad are your daily symptoms?
- Is it allergic asthma or intrinsic asthma?
- How often do you experience an attack?
- Have you had adverse reactions to any medications in the past?
Generally, you’ll start with the least amount of asthma medication needed to control your symptoms, and add more (or change medications) when you run into a problem. The dosage is increased in small steps, as needed; if you’re able to manage your asthma very well for an extended period of time, your dose may even be reduced.
The aim is to find the lowest effective dose to control your symptoms without pumping your body with more medication than necessary.
