Medication Therapy

Although there is no cure for asthma, there are a variety of asthma medications that can lead to fewer asthma attacks and less frequent symptoms. The appropriate use of asthma medications allows people with asthma to lead more active lives.

There is no one ideal drug regimen for everyone. Medication programs must be directed to every individual patient’s needs. Monitoring a patient’s asthma and collaborating with the child’s doctor on a constant basis is the best way to make sure that the medication program is suitable for the asthmatic.

There are two general categories of asthma medicine:

• Long-Term Control Medication
• Quick-Relief Medication

Long-term Control Medication

Long-term control medications are used on a daily basis to keep control of asthma and avoid asthma symptoms. The patient needs to continually take these medications even when their asthma seems improved.

There are varaities of long term control medications:

Inhaled Steroids

They reduce swelling inside the airways and may also decrease mucus production. Some of them can increase lung function. They are the most effective therapy. Some parents have concerns about the use of corticosteroids suppressing growth in children. Studies do not support this theory and have shown no growth inhibition in users, even over several years of treatment.

Common inhaled steroids include:

• Flixotide® (fluticasone)
• Pulmicort® (budesonide)

Leukotriene Modifiers
Some cells in the airways produce chemical signals called “leukotrienes” that lead to inflammation in the lungs. The inflammation results in airway smooth muscle contraction and tissue swelling. Leukotriene modifiers decrease swelling and relax muscles around the airways. They are less effective than inhaled steroids.

Common leukotriene modifiers are:

• Singulair® (montelukast)
• Zyflo® (zileuton/not indicated for children under 12 years)

Inhaled Steroid and Long-Acting Beta-Agonist
This combination is efficient at improving asthma symptoms and lung function. The inhaled steroid aids in preventing and minimizing swelling inside the airways while the long acting beta-agonist opens the air passage to the lungs by relaxing smooth muscle around the airways.

Common combinations of inhaled steroid and long acting beta-agonist include:

• Seretide® (fluticasone and salmeterol)
• Symbicort® (budesonide and formoterol)

Immunomodulator

Xolair® (omalizumab) is a medication prescribed as an injection that intervenes with the function of an immune system antibody called IgE, which tells immune cells to begin allergic reactions. This may bring on symptoms such as coughing, wheezing, nasal congestion, hives and swelling. This medication can be additional to medications in people with severe persistent asthma. Consult your doctor about side effects, and special safety measures to take when using this medicine.

Quick-relief Medication

Quick-relief medications are used to treat asthma symptoms or an asthma attack once it has started or when it can be predicted following exposure to a known allergen or when peak flow meter numbers start to drop. Monitoring Asthma.

Quick-relief medications are not a replacement for long-term control medications. They can have an effect in about 15 minutes from inhalation.

The most commonly used quick relief medication is the Ventolin inhaler. Ventolin should not be started independantly without a consultation from your doctor. In patients with prescribed Ventolin inhalers, these should not be used more than every four hours during an attack or otherwise. If there is no improvement, the nearest medical facility should be visited without further delay.

Important Note:
                                                                                                                                               
Your asthma may not be under good control if:

• you are using your quick-relief medications more than twice a week,
• you visit the emergency department for an asthma attack,
• you are hospitalized for an asthma attack

If any of these happen, see your doctor about changing or adding a controller medication for your asthma.

Metered-Dose Inhaler with Spacer:

At our clinics, physicians often recommend using a spacer. A spacer is a device which can be attached to the metered-dose inhaler. A spacer helps deliver the medication to the airways of the lungs, instead of the mouth. This helps the medication function better and must be used always with the metered-dose inhalers.