A B C D E F G H I J K L M N O P R S T U V W

ASTHMA DRUGS

What are the types of Asthma Drug ?

The drugs consist of two main types. Preventers include inhaled steroids such as beclomethasone (Becotide, Becloforte), budesonide (Pulmicort), and fluticasone (Flixotide). Other preventers include inhaled cromoglycate (Intal) and nedocromil (Tilade). Montelukast and zafirlukast are available in tablet form and are also sometimes used to prevent asthma. Relievers are available in different forms: inhalers, tablets or capsules and syrup. They include a group of drugs called beta-agonists like salbutamol (Ventolin), terbutaline (Bricanyl), bambuterol (Bambec), fenoterol (Berotec), reproterol (Bronchodil) and tolubuterol (Respecal). Salmeterol and fomterol (Oxis, Foradil) are also beta-agonists with more preventive than relieving actions. Other relievers which can be inhaled include ipratropium (Atrovent) and oxytropium (Oxivent). Occasionally theophylline (Nuelin, Slo-Phyllin, Uniphyllin, Theordur, Lasma) and aminophylline (Phyllocontin) may be used.

What are Asthma Drugs for ?

In asthma, the air passages in the lungs become narrower. This is partly because the muscles controlling the air passages contract. The narrowing is made worse by the inflammation in the air passages which get blocked by mucus. Preventers prevent the attacks by reducing inflammation. Relievers are used when the attack of asthma is already happening, and normal breathing needs to be restored. It is common for both types of drugs to be used in the same patient.

How do Asthma Drugs work ?

Relievers relax the muscles of the air passages, thereby opening them to allow easier breathing. They are short acting and work well when given as a spray, inhaler or mist. They can also be given by tablet or syrup. Some preventers (e.g.salmeterol and fomterol) may also relax the muscles of the air passages. Other preventers such as steroids, cromoclycate and necrodomil work to prevent asthma attacks by reducing inflammation of the air passage linings. They are long-acting and may be given as tablets, capsules or by inhalation. They do not work quickly enough to be used as relievers once an asthma attack has occurred.

How should Asthma Drugs be used ?

Mild and infrequent attacks of asthma are just treated with a reliever, usually salbutamol or terbutaline. It is wise to have an inhaler with you at all times, since attacks can be unpredictable. If there are certain things that always cause you to have an asthma attack, such as sport, you might try taking a dose of your reliever before you start your sport. This is better than waiting until you get breathless.

If recommended by your doctor, preventers (steroid or cromoglycate inhalers) should be used every day, regularly. They should be taken whether or not you feel breathless. They will help you to reduce the number of asthma attacks you get. If you use both a reliever and a preventer, always use your reliever inhaler first and follow up with the preventer 2 to 4 minutes later. This will give you the best effect by allowing the preventer to penetrate deeper into the air passages. Each type of inhaler device is different. Read the instructions carefully. If you are not sure, ask your pharmacist, doctor or practice nurse how it works. You may need to discuss different types. Adding a "spacer" to your inhaler may make it more effective, too. If you find that your usual dose of reliever does not help as it should, see your doctor straight away. Your asthma may be getting worse: you may need to have steroids by mouth. High doses are given for a few days. They are then either stopped or gradually reduced over a couple of weeks. A very small number of people with asthma need longer-term steroids.

During Treatment

If you take your asthma drugs by inhaler, you are not likely to get any side-effects. Very little of the drug usually gets beyond the lungs. If you take a high dose of beta-agonist, you may get shaking, headache and a fast pulse with palpitations. You may then need another drug so that your beta-agonist dose can be reduced. Anticholinergic drugs may give you a dry mouth. Very occasionally, they may also cause constipation and difficulty in passing urine. Cromoglycate can cause coughing and throat irritation. In that case, a puff of reliever before the cromoglycate often helps. High doses of inhaled steroid can cause hoarseness and thrush infections of the mouth. You can prevent this by rinsing out your mouth after inhaling. For more details about the problems of steroid tablets, see STEROIDS. The dose of theophyllines which you need for treatment is close to the dose when side-effects occur. Palpitations, nausea, headache and difficulty sleeping are the typical symptoms. See your doctor, and a blood test will be done to see what your level of theophylline actually is.

Drug Interference

Beta-blocker drugs which are sometimes used to manage heart conditions may make asthma worse by opposing the effect of beta-agonists. Theophyllines interact with a large number of drugs. Check with you doctor that each and every other drug that you are taking is safe for you if a theophylline is being prescribed as well.

What if Asthma Drugs are not taken ?

If you stop taking your preventer, your asthma will certainly get worse, with more frequent and severe attacks. You may find that the relievers do not work as they did before. An uncontrolled attack of asthma can be fatal. If you forget to take a dose of preventer at the usual time, take it when you remember, or take the next dose a bit earlier.

General advice on using Asthma Drugs

If you have heart or blood pressure problems, the combination of theophyllines and beta-agonist could affect your condition. Tell your doctor if you are, or think you may be, pregnant. The inhaled drugs are quite safe, but your doctor will want to be sure that your asthma is well controlled: bad attacks of asthma could be dangerous to your baby. If you have any question which is not answered by this leaflet, ask your pharmacist or doctor. Keep the leaflet handy in case you need to refer to it at a later stage.

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