Dr.Kamini Silvarajan MD/AAAM

Editorial Board: Dr.Kamini Silvarajan MD/AAAM

Asthma Treatment Medication

Asthma is a chronic lung disease and about 10 – 15% of the world population suffers from asthma.Asthmatics have extra sensitive or hyper-responsive airways. The airways become irritated and narrow and constrict during an asthma attack, causing increased resistance to airflow, and obstructing the flow of the air to and from the lungs.

Most often asthma must be treated with prescription medicine. There are two main types of medicines for the treatment of asthma. Quick relief medicines, also called relievers, give rapid, short-term relief and are taken when asthma symptoms worsen potentially leading to an asthma attacks.

The effects of these medicines are felt within minutes. Long-term control medicines, also called preventers, are taken every day, usually over long periods of time, to control chronic symptoms and to prevent asthma attacks. The full effects of these medicines are felt after taking them for a few weeks. People with persistent asthma need long-term control medicines.

Some asthma drugs treat asthma by resembling two of our hormones. These two hormones are adrenaline (epinephrine) and hydrocortisone (a steroid).

Adrenaline (epinephrine) is pumped into our bloodstream when we have a sudden fright or emergency. It is the quick-acting hormone from the middle of the adrenal glands near our kidneys. It makes your pulse race, your heart thump, and readies your body for emergency action. In asthma, the medicines which resemble adrenaline quickly relieve asthma for a short time.

Epinephrine and the lungs

The lungs contain smooth muscle. Epinephrine causes smooth muscles to relax.

Specifically, epinephrine binds to beta-2-adrenergic receptors on bronchial muscle cells. This allows the bronchioles to relax, which enables intensified respiration.

It has been used historically for bronchospasm and hypoglycemia, but newer treatments for these, such as salbutamol, a synthetic epinephrine derivative, and dextrose, respectively, are currently preferred.

Hydrocortisone comes from the outer part of our adrenal glands, called the ‘cortex’. It is also partly an “emergency hormone” but it works much more slowly, for much longer, and in a completely different way to adrenaline. Medicines which resemble hydrocortisone slowly allow the lining of air tubes in an asthma sufferer to become normal.

As a result, your asthma becomes less severe and you are less likely to get asthma attacks. So these steroid medicines are called preventers. There are other asthma ‘preventers’, but the steroids are the most powerful.

Fast relief medicines are used only when seriously necessary. A type of quick relief medicine is a short-acting inhaled bronchodilator. Bronchodilators work by relaxing the muscles that have tightened around the airways. 

They help open up airways quickly and ease breathing. They are sometimes called “rescue” or “relief” medicines because they can stop an asthma attack very quickly.

These medicines act quickly but their effects only last for a short period of time. People with asthma should take quick relief medicines when they first begin to feel asthma symptoms like coughing, wheezing, chest tightness, or shortness of breath. 

Anyone who has asthma should always have one of these inhalers nearby in case of an attack. For severe attacks, your doctor may use steroids to treat the inflammation.

The most effective, long-term control medication for asthma is an inhaled corticosteroid. This medicine reduces the swelling of airways that makes asthma attacks more likely. Inhaled corticosteroids are the preferred treatment for controlling mild, moderate, and severe persistent asthma. 

They are safe when taken as directed by your doctor. Inhaled medicines go directly into your lungs where they are needed.

There are many kinds of inhalers that require different techniques, and it is important to know how to use your inhaler correctly. In some cases, steroid tablets or liquid are used for short times to bring asthma under control. The tablet or liquid form may also be used to control severe asthma.

Mostly people with asthma need both a short-acting bronchodilator to use when asthma symptoms worsen rapidly and long-term daily asthma control medication to treat the ongoing inflammation. 

Over time, your doctor may need to make changes in your asthma medication. You may need to increase your dose, lower your dose, or try a combination of medications. 

Be sure to consult your doctor to find the best treatment for your asthma. The ultimate goal is to use the least amount of medicine necessary to control and manage your asthma and to find the right medicine for you.