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Quick-Relief Asthma Medications

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Asthma Bronchodilator Inhaler
Broncho-dilators are inhaled Using a Plastic Inhaler

Quick relief asthma medications, also called rescue medications, are designed to keep you alive by providing quick relief during an acute asthma attack (episode). They are called short-acting bronchodilators because they quickly open up your airways. Quick-relief asthma medications can be separated into three distinct groups, as follows:

Inhaled Short-acting Beta-adrenergic and Beta2-adrenergic Agonists

Inhaled short-acting beta-adrenergic and beta2-adrenergic agonists are usually the best asthma medications for immediately relieving asthma attacks. They may be taken:

  • During an acute asthma attack.
  • When you first begin to feel a shortness of breath, wheezing, coughing, and chest tightness.
  • Before you feel any symptoms or signs of an asthma episode but your breathing is weaker.

These bronchodilators begin their work within minutes and can last anywhere from two to six hours. Brand names include:

  • Albuterol
  • Bitolterol
  • Levalbuterol
  • Pirbuterol

Oral and Intravenous Corticosteroids

Oral and intravenous corticosteroids may be taken to treat acute asthma attacks. They can take a few hours up to a few days to be fully effective. There are serious side effects related to the long-term use of oral and intravenous corticosteroids, which may include osteoporosis (loss of bone mineral), decreased resistance to infection, thinning of the skin, high blood pressure, cataracts, and muscle weakness. Brand names include:

  • Prednisone
  • Prednisolone
  • Methylprednisolone
  • Hydrocortisone

Anticholinergic Asthma Medications

Anticholinergic asthma medications are normally used to treat acute asthma attacks, in combination with short acting beta-adrenergic and beta2-adrenergic agonists. These medications are designed to further dilate (widen) your airways after you’ve been given a short acting beta-adrenergic or Beta2-adrenergic agonist. When used alone anticholinergic asthma medications are only marginally effective. Anticholinergic asthma medications are used mainly by doctors in emergency departments. Brand names include:

  • Ipratropium

Long-term Controller Asthma Medications

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Long Term Controller Asthma Medications
Two Examples of Long Term Controller Asthma Medications
Long-term-controller asthma medications, also known as controller asthma medications, are designed to be taken on a daily basis for the control of persistent asthma.

Long-term-controller asthma medications help control the inflammation of your airways, which is directly associated with asthma. They prevent your airways from reacting to whatever it is that triggers your asthma. Long-term controller asthma medications are effective if taken every day, as directed by your doctor.

Drug manufacturers have taken very different approaches to providing long-term relief to asthma sufferers. I’ll be discussing five of these here:

Cromolyn

Cromolyn (brand name Intal) and Nedocromil (brand name Tilade) are inhalants that are designed to prevent mild to moderate asthma episodes. They are not effective for everyone, but have shown promise in the prevention of exercise triggered asthma attacks.

Inhaled Corticosteroids

Inhaled corticosteroids are anti-inflammatory asthma medications. They are the most effective medications for the long-term treatment of asthma. Corticosteroids are designed to decrease the amount of your asthma attacks and reduce the need for any other asthma medications you may use. Inhaled corticosteroids deliver anti-inflammatory asthma medication directly to your airways and effectively control most forms of asthma.

When used as directed, inhaled corticosteroids have a low risk of side effects and can help minimize your need for oral corticosteroids (which have a higher risk of side effects). Brand names include:

  • Advair (fluticasone + salmeterol)
  • AeroBid (flunisolide)
  • Azmacort (triamcinolone)
  • Flovent (fluticasone)
  • Pulmicort (budesonide)
  • Qvar (beclomethasone)

Leukotriene Modifiers

Leukotriene modifiers or anti-leukotrienes are asthma medications designed to block the action of or reduce the production of leukotrienes. Leukotrienes are substances released by cells in your lungs that cause the lining of your airways to become inflamed. Once your airways are inflamed you begin to wheeze, you are short of breath and your body begins to produce mucus.

Generally, anti-leukotrienes are not as effective as inhaled corticosteroids, although used in conjunction with other medications, especially inhaled corticosteroids, leukotriene modifiers may help prevent more asthma episodes. They are certainly an option if you have mild asthma and do not want to use inhaled corticosteroids. Brand names include:

  • Accolate (zafirlukast)
  • Singulair (montelukast)
  • Zyflo (zileutin)

Inhaled Long-acting beta2-Adrenergic Agonists (LABA’s)

Inhaled long-acting beta2-adrenergic agonists (LABA’s) are bronchodilators — asthma medications designed to open up your airways. They normally have a positive effect on your asthma symptoms for at least 12 hours. Your doctor may decide to recommend this type of asthma medication to you to prevent nighttime asthma symptoms.

They are normally only prescribed to control moderate to severe asthma symptoms. These can be used in combination with inhaled corticosteroids and should never be used as the main treatment for your asthma. Brand names include:

  • Foradil Aerolizer (formoterol)
  • Serevent Diskus (salmeterol)

* The Food and Drug Administration issued a public health advisory for three LABA asthma medications. On November 18, 2005 the FDA issued a warning that the three asthma medications identified may in fact increase the risk of severe asthma episodes and could possibly lead to death if a severe asthma attack occurs. The three LABA’s are:

  • Advair (fluticasone + salmeterol)
  • Foradil Aerolizer (formoterol)
  • Serevent Diskus (salmeterol)

If you are experiencing asthma attacks, and you are taking one of these medications, please discuss the FDA’s public health advisory with your doctor.

Theophylline

Theophylline is an oral bronchodilator. It comes in a pill form and may be helpful in relieving your nighttime asthma symptoms. Theophylline has been associated with some severe side effects. You may experience severe abdominal pain, acid reflux, nausea and vomiting, diarrhea, confusion, nervousness, and a fast or irregular heartbeat. Brand names include:

  • Slo-bid
  • Theo-Dur
  • Theo-24
  • Uni-Dur

Most long-term controller asthma medications have proven to be very effective and safe to use everyday. As always, be sure to discuss all of your treatment options with your doctor.

Asthma Medication Delivery Systems

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Metered Dose Inhaler with Spacer
Metered Dose Inhaler with a Spacer Attached

Generally, inhalers work better when used together with holding chambers. If you have trouble coordinating the release of your asthma medication from your MDI with your breathing, use a chamber device. When used properly, MDI’s with holding chambers have been shown to work as effectively as nebulizers.

There are five common asthma medication delivery systems:

  1. Metered-dose Inhalers (MDI’s)
  2. MDI’s with Holding Chamber (larger volume spacers with one-way valves)
  3. Nebulizers
  4. Dry Powder Inhalers (DPI)
  5. Autohalers (Breath-activated MDI’s)

Keep the following in mind concerning your MDI’s:

  • Nebulizers are an effective option for you if you have problems using MDI’s.
  • Try to always use a holding chamber when taking inhaled steroids (except DPI’s).
  • Keep extra inhalers on hand (separate inhalers for work, home, school, child care).
  • Use spacers every time you need to improve your inhaled medication delivery.
  • See your health care provider regularly, as medicine doses or asthma severity may, and normally do, change over time.
  • Remember to take inhaled medications before sports or exercise, if you need them.
  • Always Use a peak flow meter to regularly monitor your asthma.
Where to buy Holding Chambers:

Xolair (Omalizumab) – Allergic Asthma Medication

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Xolair Allergic Asthma Medication
Xolair (Omalizumab) is an asthma medication designed to treat allergy induced asthma.

Xolair (Omalizumab) is an asthma medication designed to treat allergy induced asthma. Xolair blocks your immune system’s response and reaction to generally benign common allergens which act as triggers, such as animal dander, food additives such as sulfites, mold, chemicals, drugs, dust mites, cockroaches, exhaust fumes, feathers, and tobacco smoke.

Xolair blocks allergy causing IgE antibodies produced by your immune system to attack substances which have entered your body. If you suffer from allergic asthma, Xolair may significantly reduce the number and severity of the asthma attacks (episodes) you will experience by blocking the action of your IgE antibodies.

Xolair asthma medication treatments involve injections every two to four weeks. Your doctor may recommend Xolair asthma treatments if you’re at least 12 years of age, if all other treatment options have been a failure and you suffer from allergy induced asthma with moderate to severe symptoms.

There are serious side effects and risks associated with Xolair. They may include possible blood-clotting problems, possible links to cancer which are currently being researched and the risk of severe reaction within two to three hours of taking the injection. As always, discuss your asthma treatment options, including Xolair, with your care providers and make an informed decision.