Asthma is a chronic lung disease that affects over 22 million people in the United States as reported by the National Heart Lung and Blood Association. Asthma causes increased mucus production and inflammation in the bronchial tubes, known as the airways, which narrows them. The characteristic symptoms including wheezing, shortness of breath, coughing and chest tightness vary in intensity from mild to severe. There are many different medications to treat this chronic disease that has no cure, including those that are long-acting, which means they go into effect gradually, and those that are short-acting, which go into effect quickly.
Inhaled Corticosteroids
Corticosteroids are synthetically produced chemicals that closely resemble cortisol, a hormone produced by the adrenal gland in the body. Inhaled corticosteroids deliver the drug directly to the airways and lungs. This type of medication works by inhibiting the production of substances, such as prostaglandins, that trigger the white cells in the body to produce an inflammatory response.
Inhaled corticosteroids such as flunisolide, beclomethasone dipropionate and budesonide are the most effective long-term medications, according to the New York City Asthma Initiative. This type of medication is taken on a regular basis and it takes several to feel the full effects. Inhaled corticosteroids do not stop an asthma attack but instead work to reduce mucus production and inflammation.
Oral Corticosteroids
Oral corticosteroids, such as prednisone and methylprednisolone, can help to relieve the inflammation of chronic asthma. The risk of side effects of oral corticosteroids is much greater than that from inhaled corticosteroids because the medication reaches the whole body instead of only the respiratory system. Side effects include increase in blood pressure, mood swings, weight gain, high blood sugar and increase risk of infections.
Beta Agonists
Beta agonist medications work by activating the beta-2 receptors on the muscles surrounding the airways. This causes the muscles to relax which opens up the airways. There are two types of beta agonist medications: short-acting and long-acting.
People with asthma take long-acting beta agonists, including salmeterol and formoterol, both inhaled medications, to reduce inflammation. These medications can trigger a severe asthma attack so the doctors at the Mayo Clinic recommend taking them with inhaled corticosteroids.
Short-acting beta agonists, also called rescue inhalers, rapidly dilate the bronchial tubes therefore relieving the symptoms of an asthma attack. Albuterol, levalbuterol and pirbuterol are all short-acting beta agonist medications that work within minutes.
Leukotriene Modifiers
Leukotrienes are chemicals produced by the body that promote airway constriction, mucus production and inflammation. Leukotriene modifiers, such as montelukast, zafirlukast and zileuton, are oral medications that work to block the production of leukotrienes or inhibit their actions.
Leukotriene modifiers are long-term medications that are usually taken once a day to help prevent asthma symptoms. Side effects include agitation, aggression, depression and suicidal thoughts. The American Academy of Family Physicians reports that leukotriene modifiers are beneficial but are considered a third-line, add-on medication for any chronic asthma treatment plan.
