Many people with asthma take two kinds of medications: "long-term" maintenance medications to prevent an asthma attack, and "rescue" medications to provide rapid, short-term relief at the onset of symptoms. Asthma medications are taken orally, by metered dose inhaler (MDI), by dry powder inhaler (DPI), by nebulizer and injection. Your doctor will determine the medication type, dose, and duration based on your pulmonary function test results, your overall health and the frequency and severity of your asthma symptoms, which can vary seasonally.
Long-Term Corticosteroids
Long-term maintenance medications are taken on a regular basis to control chronic asthma symptoms and prevent asthma attacks. Inhaled corticosteroids, such as Flovent, Pulmocort, Asmacort, Aerobid, Ovar and Asmanex, are antiinflammatory drugs that reduce airway inflammation and block allergen response. You take these using a metered dose inhaler, preferably with a spacer.
One unpleasant side effect of taking these drugs is mouth and throat irritation and oral yeast infections, so it is wise to rinse out your mouth after each use. Other side effects from inhaled corticosteroids are minimal.
Long-Term Bronchodilators
Long-term bronchodilators, such as Serevent, Atrovent, and the Spiriva Handihaler, are maintenance medications, taken to prevent narrowing of the airways by keeping inflammation under control. These medications can take up to 20 minutes to take effect, so you should not use them as rescue medications. Long-term bronchodilators control moderate to severe asthma and are used regularly with a corticosteroid.
Theophylline is another bronchodilator, available in pill form, and it controls mild persistent asthma.
Rescue Bronchodilators
Quick-relief, short-acting rescue medications relieve the sudden onset of wheezing, coughing, and shortness of breath. These short-acting bronchodilators prevent symptoms from getting worse. They work quickly, usually within minutes, and the effects last for four to six hours. Some quick-relief medications include AccuNeb, Proventil, Ventolin, Xopenex, and Maxair, although in combination with long-acting medications, they can be used as maintenance drugs. Atrovent is sometimes given as a secondary rescue medication. These drugs are most often administered by metered dose inhaler; however, they can be nebulized as well.
Mixing Medications
Bronchodilator combination drugs are packaged within a single vial and include the Duoneb (albuterol and Atrovent) taken by nebulizer; Combivent (albuterol and Atrovent) taken by metered dose inhaler; and Advair (Serevent and Flovent) taken by Dry Powder Inhaler diskus. Before combining medications, consult with your physician, because combining two or more drugs could cause serious side effects. Adding similar drugs could easily cause an overdose or unexpected side effects.
References
- U.S. Department of Health & Human Services: National Heart Lung and Blood Institute, Guidelines for the Diagnosis and Management of Asthma
- MayoClinic.com: Asthma
- Cleveland Clinic: Medications for Treating Asthma
- American Academy of Allergy Asthma & Immunology: Tips to Remember: Asthma & Allergy Medications
