Understanding Asthma Treatments - Relievers and Preventers
Copyright 2006 David Drinkall
Millions of people around the world suffer from Asthma, a
chronic lung condition characterized by difficulty in breathing.
During an asthma attack, the sufferer's airways become irritated
and react by narrowing and constructing. That causes increased
resistance to airflow, and obstructs the flow of the air to and
from the lungs.
How is asthma treated?
Asthma is treated using two main types of medicines:
* Quick Relief Treatments: also called relievers. These give
rapid, short-term treatment and are taken when you have
worsening asthma symptoms that, left untreated, can lead to
asthma episodes or attacks. You will feel the effects of these
medicines within minutes.
* Long-Term Control Treatments: also called preventers, and are
for people with persistent asthma, who need long-term control
medicines. Preventers are taken every day, usually over long
periods of time, to control chronic (long-term) symptoms and to
prevent asthma episodes or attacks. You will feel the full
effects of these medicines after taking them for a few weeks.
Drugs related to hormones
Drugs, such as those resembling two of our hormones, can help
treat asthma. These two hormones are epinephrine (adrenaline in
the UK) and hydrocortisone (a steroid). Epinephrine is pumped
into our bloodstream when we have a sudden fright or emergency -
psychologists often call this state fright or flight.
Epinephrine is the quick-acting hormone from the middle of the
adrenal glands near our kidneys. It makes your pulse race, your
heart thump, and readies your body for emergency action. In
asthma, the medicines which resemble adrenaline quickly relieve
asthma for a short time, and are from the reliever family.
Hydrocortisone comes from the outer part of our adrenal glands,
called the 'cortex'. It is also partly an "emergency hormone"
but it works much more slowly, for much longer, and in a
completely different way to adrenaline. Medicines which resemble
hydrocortisone slowly allow the lining of air tubes in an asthma
sufferer to become normal. As a result, your asthma becomes less
severe and you are less likely to get asthma attacks. So these
steroid medicines are part of the preventer family. Steroids are
the most powerful preventers currently available.
Other long-term treatments include:
* Long-acting beta-agonists are bronchodilators, not
anti-inflammatory drugs. These medicines are used to help
control moderate and severe asthma and to prevent night-time
symptoms. Long-acting beta-agonists are taken together with
inhaled corticosteroids
* Leukotriene modifiers (such as montelukast, zafirlukast, and
zileuton) are long-term control medicines used either alone to
treat mild persistent asthma or together with inhaled
corticosteroids to treat moderate persistent asthma or severe
persistent asthma.
* Cromolyn and nedocromil are used to treat mild persistent
asthma.
* Theophylline is used either alone to treat mild persistent
asthma or together with inhaled corticosteroids to treat
moderate persistent asthma. People who take theophylline should
have their blood levels checked to be sure the dose is
appropriate.
Be careful. If you stop taking long-term control medicines, your
asthma will likely worsen again.
Taking preventers
Inhaled corticosteroids (or steroids for short) are the
preferred treatment for controlling mild, moderate, and severe
persistent asthma. They are safe when taken as directed by your
doctor.
Inhaled medicines go directly into your lungs where they are
needed. There are many kinds of inhalers that require different
techniques, and it is important to know how to use your inhaler
correctly.
Usually the best way to take these medicines is to breathe them
in. That is, you inhale them, through your nose or mouth. The
reasons you inhale them are: * because you need less of the
medicine, * you won't suffer as many side effects, and, * the
medicine works more quickly,
The final point is particularly important with the
adrenaline-like, fast-acting relievers.
Another advantage is that the hydrocortisone-like steroid
preventers you breathe in can be chosen to be biodegradable
inside the body. As a result, then can do their work in the
lung, but don't get much of a chance to produce any side effects
in the rest of your body, because your liver breaks them down.
In some cases, steroid tablets or liquid are used for short
times to bring asthma under control. The tablet or liquid form
may also be used to control severe asthma.
Taking quick relief medicines
Quick relief medicines are used only when needed. A type of
quick relief medicine is a short-acting inhaled bronchodilator.
Bronchodilators work by relaxing the muscles that have tightened
around the airways. They help open up airways quickly and ease
breathing. They are sometimes called "rescue" or "relief"
medicines because they can stop an asthma attack very quickly.
These medicines act quickly but their effects only last for a
short period of time. You should take quick relief medicines
when you first begin to feel asthma symptoms like coughing,
wheezing, chest tightness, or shortness of breath. Anyone who
has asthma should always carry one of these inhalers in case of
an attack. For severe attacks, your doctor may also use steroids
to treat the inflammation.
Work closely with your doctor
Many people with asthma need both a short-acting bronchodilator
to use when symptoms worsen and long-term daily asthma control
medication to treat the ongoing inflammation. Over time, your
doctor may need to make changes in your asthma medication. You
may need to increase your dose, lower your dose, or try a
combination of medications. Be sure to work with your doctor to
find the best treatment for your asthma. The goal is to use the
least amount of medicine necessary to control your asthma.