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What Medications Are Used to Treat Asthma?
There are two kinds of medications:
• Reliever medications: These are medications that act quickly to relax muscles that have tightened around the airways and promptly relieve your asthma symptoms. Reliever medications are:
_ Short-acting bronchodilators and include:
_ Inhaled beta2-agonists (Albuterol, Proventil and Ventolin);
_ Ipratropium (Atrovent); and
_ Short courses of oral steroid medications (Prelone, prednisilone).
• Controller medications: These are medications taken every day to control your asthma and help prevent attacks. The most preferred controller medications are inhaled anti-inflammatory drugs that reduce or reverse the swelling in the airways that caused your asthma symptoms. These medications also prevent the swelling from starting, which keeps asthma episodes from starting. These medications include:
_ Cromolyn sodium (Intal);
_ Inhaled corticosteroids (Flovent, Vanceril, Azmacort); and
_ Oral leukotriene inhibitors.
Other types of controller medications include long-acting bronchodilators that are used together with the anti-inflammatory medications. The most commonly used of these agents are long-acting inhaled salmeterol and oral sustained-release theophylline.
How Are Asthma Medications Prescribed?
Each patient's asthma is different. Each patient's airways react to different triggers at different times and with different symptoms. Also, different people respond to different asthma medications. As a result, asthma medications must be prescribed for each person's special needs. This involves close work with your physician and may take some time to find out which medications work best for you.
What Is an Asthma Management Plan?
An asthma management plan tells you what medicine to take and when to take it. It will help you take your medications the right way.
1. Reliever medications: If you have symptoms only every now and then (less than once or twice a week), a short acting inhaled bronchodilator may be all you need to control asthma symptoms. If you have an asthma episode, your physician may tell you to take more of your bronchodilator medication. This may be enough to relieve your symptoms. However, a second medication may be prescribed for serious episodes. Your asthma action plan will give you more information on medications to take during asthma episodes.
If exercise is one of your asthma triggers, your physician may prescribe an inhaled short acting bronchodilator before exercise. This will keep an episode from starting.
2. Controller Medications: Your physician will prescribe an anti-inflammatory medication to reverse and prevent the swelling that causes the symptoms of asthma. If you have symptoms more than once or twice a week, you need an anti-inflammatory medication. You need to take this medication EVERY DAY, even on days when you don't have symptoms. For asthma patients with allergies, some physicians may also prescribe an extra dose of cromolyn, one kind of anti-inflammatory drug. Patients are instructed to take this does before coming in contact with a known trigger (for example, before visiting the house of a friend or relative who has a cat).
REMEMBER: If your asthma management plan is not working and you still have symptoms with exercise, at rest, at night, or early in the morning, you need to review your asthma management plan with your physician. Before changing your medications, your physician will want to reevaluate your trigger control measures, administration of your technique of administering your inhaled medications, the severity of your asthma, and any problems that you have taking your medications.
Are Asthma Medications Safe?
All medications have the potential for side effects, but if asthma medications are taken as directed their side effects should be minimal or, if they occur, can be managed. Some people are afraid that they will become addicted to their medications. This is not true. Others are concerned that if medication is taken all the time, it will no longer work; or if pregnant, that the medication will affect the growth and development of their child. Talk to your physician about your concerns.
What to Do If Side Effects Occur:
• Report all side effects to your physician immediately.
• Do not stop taking the medication completely until you talk to your physician. This may cause your asthma to get worse.
Tips for Correct Use of Medications:
• Take your inhaled, short-acting bronchodilator medication at the earliest sign that your asthma is getting worse. Watch out for early signs (a drop in your peak flow number or feeling symptoms such as cough, chest tightness, wheezing, or being short of breath) so that asthma medication can be started right away to relieve symptoms. An asthma episode is easier to stop if you take your medication as soon as symptoms start. You won't have to take as much medication that way.
REMEMBER: Inhaled bronchodilators relieve symptoms, but they cannot reduce or prevent the airway swelling that causes the symptoms to return or persist. When you have to use a bronchodilator frequently, it may be a sign that the swelling in your airways is getting worse. If your bronchodilator medication does not seem to work as well or for as long as it previously had, this may be a sign that your asthma is getting worse. If you use an inhaled short-acting beta2-agonist to relieve symptoms every day or if you use it more than three or four times in a single day, your asthma may be getting much worse. You probably need another kind of medication. Discuss this with your physician right away.
• Take your prescribed controller medication (example, inhaled and oral anti-inflammatory drugs) exactly the way your physician recommends, even if you do not have any symptoms. This will reduce airway swelling and will keep asthma episodes from starting. This medication must be taken regularly for it to work well.
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