Asthma is a chronic obstructive respiratory disease in which the small airways of the lungs, called the bronchioles, constrict. The airways may also fill with mucus, which works together with constriction to make breathing quite difficult. Asthma control treatments fall into two separate categories; some medications stop acute attacks, while others are meant to prevent attacks from occurring in the first place.
Rescue Inhalers
One of the most important tools in an asthmatic's control arsenal is a rescue inhaler. These contain medication, commonly albuterol, that relaxes the muscles of the bronchioles and expands airways to stop asthma attacks and prevent them from becoming life-threatening. Drugs.com notes that in addition to stopping asthma attacks, albuterol can also help prevent exercise-induced asthma if it's used before exercise. Albuterol falls into a class of drugs called short-acting beta agonists and may lead to side effects like a racing or pounding heart.
Inhaled Corticosteroids
Many decades ago, systemic steroids like prednisone were sometimes prescribed to help prevent asthma attack by reducing overall inflammation and immune symptom response, which helps reduce respiratory inflammation. Inhaled corticosteroids have largely replaced systemic steroids, since they have fewer side effects and deliver the steroid medication directly to the affected tissues. Notes ConsumerReports.com, patients with uncontrolled asthma who experience flare-ups and attacks frequently often benefit from use of an inhaled corticosteroid. All inhaled steroids used in asthma control are by prescription only.
Long-Acting Beta Agonists
Like short-acting beta agonists found in rescue inhalers, long-acting beta agonists reduce swelling and constriction of the muscles of the small airways, but they act more slowly and their effects are longer-lasting. One common long-acting beta agonist is salmeterol, available by prescription. A 1997 study in the "British Medical Journal" showed that patients treated with salmeterol showed significantly reduced reliance upon inhaled corticosteroids and reduced incidence of acute asthma attack. Like short-acting beta agonists, salmeterol can cause cardiac symptoms including rapid heart rate and palpitations.
Leukotriene Inhibitors
Since many asthma attacks are allergic in origin, meaning that they are the result of inflammatory responses initiated by immune cells, some asthma control medications attempt to reduce incidence of asthma attacks by preventing immune cells from releasing inflammatory compounds. One such class of compounds, called leukotrienes, are particularly active in causing constriction of the small airways. The drug montelukast, marketed under the brand name Singulair, is a leukotriene inhibitor, explains Drugs.com. Regular use helps prevent both allergy and asthma attacks, and some patients find that it enhances the effectiveness of other asthma control regimens.
References
- Drugs.com: Albuterol
- ConsumerReports.com: Steroids
- "BMJ"; Effect of long term treatment with salmeterol on asthma control: a double blind, randomised crossover study; Paul Wilding et al.; May 1997
- Drugs.com: Singulair
