Asthma is a lung disorder characterized by hypersensitivity of the airways. This leads to spasms and constriction of the bronchioles followed by inflammation. Chemicals are released in the inflammatory process that cause swelling and narrowing of the airways. Certain medications treat the bronchospasm while others treat the swelling and inflammation. Some medicines work quickly to relieve symptoms and some are for long-term control and maintenance.
Short-Acting Beta-Agonists
Short-acting beta-agonists are medications that work quickly to relax the bronchospasm associated with asthma. For this reason, they are often termed "rescue medications." Albuterol, pirbuterol, and levalbuterol fall into this category. They usually are administered in a metered dose inhaler but are also available in a solution for use in a nebulizer or in oral forms.
Long-Acting Beta-Agonists
Long-acting beta-agonists are similar to the short-acting beta-agonists in that they relax the smooth muscle in the airways to relieve spasms. They take longer to begin working, but their effects last longer. These medications are not meant to be used in urgent situations. These drugs, including salmeterol, formoterol, and aformoterol, are available in dry powder inhalers or a nebulized solution.
Corticosteroids
Corticosteroids block the key causes of the inflammation. They are the most effective treatment available for asthma. Inhaled corticosteroids such as beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone, mometasone and triamcinolone are usually used daily to control asthma. During exacerbations, oral or even intravenous forms of corticosteroids are sometimes used.
Leukotriene Receptor Antagonists
Leukotriene receptor anatagonist drugs block a specific pathway in the inflammatory process and are used for long-term therapy. Montelukast, zafirlukast and zileuton are taken orally. They are not considered the first choice of drugs for the treatment of asthma.
Mast Cell Stabilizers
Mast cell stabilizers, as their name implies, stabilize cells that are involved in the inflammatory pathway. They are another alternative treatment. They are more commonly used in children than adults. Cromolyn and nedocromil are both available as metered dose inhalers and are sometimes used to prevent episodes of cold air or exercise-induced asthma.
Anticholinergic
Ipratropium bromide is considered a quick-relief bronchodilator. It is often used in combination with or as an alternative to albuterol. It comes in an inhaler or in solution form for use in a nebulizer.
Immunomodulator
Omalizumab is an antibody that blocks IgE, which is involved in the inflammatory response of asthma. It is administered in a doctor's office by injection for people with severe asthma triggered by allergies.
Methylxanthine
Theophylline is a bronchodilator that is not often used to treat asthma. It is taken orally and works to relax smooth muscles around the airways. Its use must be monitored closely due to its side effects and drug interactions.
