Asthma medications fall into two categories: long-term control medications and rescue, or quick-relief medications. The National Asthma Education and Prevention Program Expert Panel developed a therapy approach to administering asthma medications. This approach, based on severity, includes Step 1: mild intermittent; Step 2: mild persistent; Step 3: moderate persistent; and Step 4: severe persistent. Medications can be listed under a brand or generic name.
Inhaled Corticosteroids
To manage the symptoms of chronic asthma, inhaled corticosteroids serve as Step 2 maintenance medications. Brand names of these drugs include QVAR, Asmacort, AeroBid, Aerospan, Flovent HFA, Flovent diskus, Pulmicort Turbuhaler, Pulmicort Respules, Asmanex Twisthaler, Advair diskus, Advair HFA and Symbicort. All of these drugs can be taken either by metered dose inhaler, dry powder inhaler, or by small volume nebulizer.
Long-Acting Bronchodilators
Maintenance medications include long-acting bronchodilators. These drugs relieve the spasms that cause narrowing of the bronchial airways. Brand names in this category include Serevent, Foradil and Brovana, all long-acting beta-2 drugs. Beta-2 drugs relax the bronchial smooth muscle and inhibit the inflammatory response. These drugs have a slower onset and a longer duration of action as compared to rescue drugs.
Cromolyn and Theophylline
Non-steroidal antiasthma medications include cromolyn and nedocromil sodium, generic names for Intal and Tilade, and can be taken with a metered dose inhaler or small volume nebulizer. As Step 2 drugs, Intal and Tilade are mast cell stabilizers, also called antileukotrienes, used to treat the inflammation response in airway diseases such as asthma. Sustained-release theophylline is generally a second-choice or alternative drug for Step 2 therapy because it has a weak bronchodilating effect compared to other drugs.
Leukotriene Modifiers
Leokotrienes are chemical mediators, or bullies, that cause inflammation, so a leukotriene modifier stops or curtails this response. Antileukotrienes include Accolate, Singulair and Zyflo, and can all be taken in tablet form. Singulair comes in tablets, chewable tablets and oral granules.
Immuno Modulators
Used to treat moderate to severe asthma, omalizumab, the generic name for Xolair, is given by injection and also treats seasonal allergies. Xolair blocks or minimizes the allergic response to allergens, and is not meant as a replacement for corticosteroids.
Short-Acting Beta Agonists
This category encompasses rescue, or quick-acting medications. A B2 agonist relieves airway obstruction and wheezing. These short-acting beta agonists are the first drugs of choice for status asthmaticus, as well as chronic asthma, bronchitis, emphysema, and other obstructive airway diseases. Brand names include Adrenalin, Isoetharine, Alupent, Proventil--the generic name is albuterol-- Ventolin, ProAir, Maxair, Xopenex, Serevent, Foradil and Brovana. All of these drugs can be taken either by metered dose inhaler, dry powder inhaler, or by small volume nebulizer.
