Treatment of Asthma

Long-term :

• Combined therapy medicine: Combined therapy involves both a controller (long-acting bronchodilator) and reliever (corticosteroid) medicine. This therapy is used to manage asthma symptoms for long-term. 
• Cromolyn sodium and nedocromil sodium: Cromolyn sodium (like Intal® and nedocromil sodium (like Tilade®) are used to help prevent the airways from swelling when they are exposed to asthma triggers. These inhaled non-steroids may also help prevent exercise-induced asthma attacks. 
• Immunotherapy: During immunotherapy (also known as allergy shots), the patient receives periodic injections, as determined by the allergist/immunologist, over the course of three to five years. The solutions in the injections contain the substances the individual is allergic to. The treatment helps the immune system tolerate the allergens and lessens the need for medications. 
• Peak flow meter: A peak flow meter is a portable device that measures airflow, or peak expiratory flow (PEF). When asthmatics blow into the device quickly and forcefully, the peak flow reading indicates how open the airways are. Patients should compare their daily peak flow recordings with their "personal best" recording. The device helps patients determine the severity of the asthma. It is enables patients to check their responses to treatment and monitor their treatment progress. 
• Inhaled corticosteroids: Inhaled corticosteroids (Aerobid®, Azmacort®, Beclovent®, Flovent®, Pulmicort® or Vanceril®) are used to prevent and reduce airway swelling, as well as decrease the amount of mucus in the lungs. These medications are generally considered safe when taken as directed. 
• Leukotriene modifiers: Leukotriene modifiers (like Accolate® or Singulair®) are a new type of long-term control medication. They help prevent airway inflammation and swelling, as well as decrease the amount of mucus in the lungs. 
• Long-acting beta agonists: Long-acting beta agonists, such as Serevent® (which is inhaled) may be taken with or without anti-inflammatories to help control persistent symptoms. Long-acting, inhaled beta agonists should not be used as a substitute for anti-inflammatories. This type of medicine may also prevent exercise-induced asthma. However, these medications cannot relieve symptoms quickly, and they should not be used to treat an acute attack. A short-acting, inhaled beta agonist should be used to treat acute symptoms. 
• Oral corticosteroids: Oral corticosteroids like (Aristocort®, Celestone®, Decadron®, Medrol®, Prednisone® or Sterapred®) are available in pill/tablet format for adults. Liquid corticosteroids (like Pediapred® or Prelone®) are available for children. These medications can be used short-term for severe asthma episodes or as long-term therapy for individuals who have severe asthma. 
• Trigger avoidance: Since asthma can be triggered by allergens, symptoms can be caused or aggravated by the environment. An allergist or immunologist can help patients recognize the allergens and irritants that trigger asthma attacks. Exposure to common irritants, including pollen, animal dander, mold spores and dust mites, may trigger asthma.

 

Eliminate potential food allergens, including dairy (milk, cheese and sour cream), eggs, nuts, shellfish, wheat (gluten), corn, preservatives and food additives (like dyes and fillers). Food allergies can be a contributing factor in immune imbalance triggering symptoms of asthma.

Short-term :

• Oral beta agonists: Oral beta agonists (like Alupent®, Brethine®, Bricanyl®, Proventil®, Repetabs®, Ventolin® or Volmax®) may be used to decrease acute symptoms that arise quickly. Oral beta agonists are available in pill, syrup and inhaled form. 
• Short-acting bronchodilators: Short-acting bronchodilators are also used for quick relief of asthma symptoms. They open airways by relaxing the muscles that tighten around airways during an asthma attack. 
• Short-acting beta agonists: Short-acting beta agonists (like Albuterol®, Brethaire®, Bronkosol®, Isoetharine®, Maxair®, Medihaler-Iso®, Metaprel®, Proventil®, Tornalate® or Ventolin®) may help relieve asthma symptoms quickly. These medications may also help prevent exercise-induced asthma. If these medications are taken daily, or if they are taken more than three times in a single day, the asthma may be worsening, or the inhaler may not be used correctly. 
• Theophylline: Theophylline (like Aerolate®, Elixophyllin®, Quibron-T®, Resbid®, Slo-bid®, T-Phyl®, Theolair®, Theo-24®, Theo-Dur®, Theo-X®, Uni-Dur® or Uniphyl®) may be used to treat persistent asthma symptoms and to prevent nighttime asthma. In order to be effective, theophylline must remain at a constant level in the bloodstream. If the level is too high, it can be potentially dangerous. A qualified healthcare provider will perform regular blood tests to ensure safety. Sustained release theophylline is not the preferred primary long-term control treatment, but it has been shown to be effective when taken with anti-inflammatories to control nighttime asthma attacks.

 

Pregnancy :

• General: Many asthma medications are considered safe for pregnant patients because the risk of adverse effects appears to be less than the risk of uncontrolled asthma. Medications that have been used in pregnant women include inhaled bronchodilators, cromolyn sodium and beclomethasone, all of which have a local effect. Theophylline has also been used during pregnancy if the asthma is not adequately controlled by the other medications. Oral steroid medications, such as prednisone, should only be used when necessary for severe asthma during pregnancy. Consult a qualified healthcare professional before beginning any treatment.