|Allergy and Asthma
Southwestern United States
||Information for patients with allergy and related
in the Southwest
Seasonal Advice, Treatment and Prevention
Control of asthma with inhaled medications
Although mild asthma may respond to treatment with oral medications such as theophylline, zafirlukast (Accolate) or montelukast (Singulair), nearly all asthmatics require inhaled medications. Inhaled medications may be delivered as
Metered dose inhalers require proper inhalation technique for the full dose to be inhaled, even when a spacer is used. Inhaler technique must be checked in your allergist's office at least once a year to maintain proficiency.
It is vitally important to understand the difference between two types of asthma drugs - bronchodilator drugs and anti-inflammatory drugs.
Bronchodilator drugs open up the airways in the lung
within minutes of inhalation of the drug, by relaxing the smooth muscle that surrounds the
Anti-inflammatory drugs work to reduce the irritability of the lung airways by controlling the activities of inflammatory cells in the airway walls. These drugs are essential to the proper control of moderate asthma. They are used to reduce asthma severity over a period of time, and must be used on a regular basis, usually 2-3 times per day. A very common cause of asthma attacks is failure to remember to take the anti-inflammatory drug regularly, as prescribed. These drugs do not provide immediate relief from an asthma attack because they do not act as bronchodilators. However, it is often advised to temporarily increase the dose of the anti-inflammatory drug during an acute attack. Two types of anti-inflammatory drugs exist - mast cell stabilizers, and corticosteroids.
Mast cell stabilizers e.g., cromolyn sodium (Intal), are effective in controlling mild asthma. Cromolyn sodium must be used 3-4 times daily for at least 8 weeks before improvement occurs. It also has a weak action in preventing wheezing from exercise when used immediately before exercise, but a short-acting bronchodilator is much more effective in preventing exercise-induced asthma. Nedocromil (Tilade) is a more effective mast cell stabilizer drug than cromolyn but has been discontinued from the US market.
Inhaled corticosteroids are the most effective means of
controlling asthma and are the usual type of drug given in the routine anti-inflammatory
management of moderate asthma. In the usual doses given they NEVER cause the long
list of side effects that accompany use of corticosteroid tablets or injections. The
only side effect to be concerned about with approved doses is Candida (thrush) in the
throat, a problem that is usually prevented by rinsing the mouth with water after each
dose. In usually recommended doses they are safe! Combined preparations
containing a corticosteroid and a long acting bronchodilator (Advair, Dulera and
Symbicort) are proving to be useful in limiting the amount of corticosteroid needed for
control of asthma.
Disclaimer: This site is for educational purposes only. Any information that you have found in this web site is not intended to replace medical care or advice given to you by your own physicians. You should consider consulting your local medical library and other web sites for additional information.
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