Claire Dawson
Asthma is a chronic inflammatory illness that affects millions of people daily, causing unscheduled healthcare usage, missed school, and workdays. There are a variety of medicines available to treat asthma, including quick-relief and long-term controller medicines. Quick-relief medicines work rapidly to relax the airways and improve breathing, while long-term control medicines reduce swelling and inflammation in the airways. Inhaled corticosteroids are the most common long-term control medicines, while short-acting beta-agonists are the first choice for quick relief. Other treatments include biologics, which are typically administered as shots or infusions every few weeks, and leukotriene modifiers, which can be taken orally as pills or liquids. Inhalers, nebulizers, and injectables are some of the most common methods of administering asthma medications in hospitals and healthcare settings.
| Characteristics | Values |
|---|---|
| Types of Asthma Medicines | Quick-relief, Long-term control, Bronchodilators, Anti-inflammatory, Biologics, Leukotriene modifiers, Monoclonal antibody immune-modulating drugs |
| Quick-relief Medicines | Anticholinergics, Short-acting beta-agonists, Combination medicines |
| Long-term Control Medicines | Inhaled corticosteroids, Inhaled long-acting beta-agonists, Combination inhaled medicines |
| Bronchodilators | Short-acting, Long-acting |
| Anti-inflammatory Medicines | Corticosteroids, Inhaled steroids |
| Biologics | Shots, Infusions |
| Leukotriene Modifiers | Pills, Liquids |
| Monoclonal Antibody Immune-modulating Drugs | Omalizumab |
| Administration Methods | Inhalers, Nebulizers, Pills, Liquids, Injections, IV |
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Inhalers
There are several types of inhalers, including metered-dose, dry powder, and soft mist inhalers. Metered-dose inhalers (MDIs or pMDIs) use a small aerosol canister to push out a short burst of medication through a plastic mouthpiece. Dry powder inhalers release the medication only when the patient takes a deep breath. Soft mist inhalers use a propellant to help the medicine move out of the canister and into the mouthpiece.
In addition to the type of inhaler and medication, it is important to use the device correctly. Patients should ask their healthcare providers to demonstrate the right way to use their prescribed inhaler. Proper inhaler technique ensures that the medication reaches the lungs effectively.
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Nebulisers
They are particularly useful for treating severe asthma attacks, as they can deliver high doses of medicine quickly and easily. Nebulisers are also used to treat flare-ups and asthma attacks at home, but only if a doctor or specialist recommends it and prescribes the medication.
If you have severe asthma, a nebuliser may be recommended for home use if you are at a high risk of severe asthma attacks, or if you have tried different inhalers without success. Nebulisers are also used to deliver saltwater solutions to help manage phlegm build-up in patients with bronchiectasis or pulmonary fibrosis.
There are portable nebulisers available, but these may be less powerful or more expensive. They can be battery-operated or plugged into a car cigarette lighter. A pump should nebulise 80% of the medication in the first 8 minutes, so for most people, a standard dose will be complete within about 10 minutes.
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Quick-relief medicines
Quick-relief asthma medications, also known as rescue medicines, are fast-acting treatments used to swiftly manage asthma symptoms such as coughing, wheezing, and difficulty breathing during an asthma attack. They are typically administered through inhalers or nebulizers, which deliver the medication directly to the lungs.
Short-acting beta-agonists are the most common type of quick-relief medication. They include medications such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA), epinephrine (Asthmanefrin, Primatene Mist), and levalbuterol (Xopenex HFA). These drugs act as bronchodilators, relaxing the muscles surrounding the airways and allowing more air to pass through, providing relief during an asthma attack. Anticholinergics, such as ipratropium (Atrovent), are another type of quick-relief medication that not only opens the airways but also reduces mucus production, further improving breathing.
Combination quick-relief medicines contain both an anticholinergic and a short-acting beta-agonist, providing dual action to treat asthma symptoms. They reduce swelling and mucus in the airways, making them less sensitive and less reactive to asthma triggers. This combination approach helps prevent asthma attacks and manage symptoms effectively.
Inhaled corticosteroids are long-term control medicines that are highly effective in managing asthma. While they are not quick-relief medications, they are often used in conjunction with quick-relief treatments to provide ongoing management of asthma. Examples of inhaled corticosteroids include beclomethasone (Qvar RediHaler), budesonide (Pulmicort Flexhaler), and fluticasone (Flovent HFA). These medications do not have the same muscle-relaxing effects as short-acting beta-agonists but are crucial in the long-term management of asthma.
It is important to note that while quick-relief medications are essential for managing acute asthma symptoms, they should not be relied upon as a long-term solution. If an individual finds themselves using quick-relief medications more than twice a week, it is recommended to consult a healthcare provider to reassess the asthma management plan and adjust the daily control medications.
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Long-term control medicines
Long-term control asthma medications are taken daily to achieve and maintain control of persistent asthma. Inhaled corticosteroids are the most effective long-term control medicines. They are not the same as anabolic steroids that people use to grow muscle. These inhaled corticosteroids include beclomethasone (Qvar RediHaler), budesonide (Pulmicort Flexhaler), ciclesonide (Alvesco), fluticasone (Flovent HFA), and mometasone (Asmanet Twisthaler). They are often used in combination with long-acting beta-agonists (LABAs) such as formoterol, salmeterol, and vilanterol. LABAs are bronchodilators that relax the smooth muscles around the airways, opening them up. However, they should not be used as monotherapy for long-term control.
Long-acting bronchodilators such as tiotropium (Spiriva) can also be used alongside inhaled corticosteroids if asthma symptoms persist despite daily steroid use. Nevertheless, long-acting bronchodilators should never be used alone as a long-term asthma treatment. Corticosteroids themselves, in pill or liquid form, are typically a last resort for controlling asthma attacks if no other medicine is effective.
Biologics are another long-term control medicine, but they are usually only used if other medications don't work due to their high cost. They target specific cells or proteins in the body to prevent airway inflammation and can be administered as shots or infusions every few weeks. Examples include benralizumab (Fasenra), dupilumab (Dupixent), and omalizumab (Xolair).
Leukotriene modifiers are available as pills or liquids and include montelukast (Singulair) and zafirlukast (Accolate). They relax the smooth muscles around the airways and reduce swelling. Similarly, cromolyn, a non-steroid medicine available as an inhaler, prevents the airways from swelling when exposed to asthma triggers. Theophylline, which comes in tablet, capsule, solution, or syrup form, relaxes the muscles that narrow the airways.
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Bronchodilators
Inhalers
Inhalers are the most common and effective way to deliver asthma medication to the lungs. Short-acting bronchodilator inhalers, also known as rescue inhalers, quickly relieve or stop sudden asthma symptoms and are effective for three to six hours. Long-acting bronchodilator inhalers, on the other hand, are used daily to prevent asthma attacks and keep airways open for up to 12 hours. It is important to use the inhaler properly to ensure the full dosage is received. The patient should shake the inhaler, remove the cap, breathe out completely, put the mouthpiece in their mouth, press the inhaler, and then take a slow, deep breath in.
Nebulizers
Short-acting bronchodilators can also be administered through a nebulizer, a battery-powered machine that creates a fine spray. This is often used for treating asthma attacks at home.
Tablets and Liquids
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Frequently asked questions
There are several types of asthma medication, including short-acting bronchodilators, long-acting bronchodilators, anti-inflammatory medicines (corticosteroids or steroids), biologics, and leukotriene modifiers.
In hospitals, asthma medication is typically administered via inhalers, nebulizers, or injections. Inhalers are the most common method, with metered-dose and dry powder inhalers being the two main types. Nebulizers are also used to deliver medication directly to the lungs. Injections, such as biologics and leukotriene modifiers, are administered less frequently, usually every few weeks.
Quick-relief medicines are used to quickly relax the airways and improve breathing during asthma attacks. They are typically administered through inhalers, with short-acting beta-agonists being the first choice for quick relief. Examples include albuterol and levalbuterol.
Long-term control medicines, also known as long-term controller medicines, are taken daily to reduce swelling and inflammation in the airways and prevent asthma symptoms. These are often inhaled corticosteroids, such as beclomethasone and budesonide, which are administered once or twice daily through inhalers.
Yes, there are combination medicines that treat symptoms and prevent asthma attacks. They reduce swelling and mucus in the airways. These typically combine an anticholinergic with a short-acting beta-agonist, such as ipratropium bromide/albuterol. They can be administered through inhalers or nebulizers, depending on the patient's needs.
