Medical Guides

Drugs used in the management of asthma

Asthma medicines can be classified into two groups:

Relievers or Quick-Relief Medicines or Rescue Medicines

These are fast-acting bronchodilators that relieve bronchoconstriction and it’s accompanying acute symptoms. Salbutamol, Terbutaline, Ipratropium Bromide, Aminophylline infusions, Deriphylline injections, Adrenaline injections are reliever medicines.
Controllers or Prophylactic, Preventive, or Maintenance Medications

These are useful in achieving and maintaining asthma under control. Gluco-corticosteroids, sodium cromoglycate, long-acting beta 2-agonists

- Salmetrol & Fometrol, sustained release tablets of theophylline are controller medicines. Inhaled glucocorticosteroids are the most effective controllers.

Bronchodilators

These are medicines that relax the muscles around the airways. Salbutamol, terbutaline, theophylline and ipratropium are bronchodilators. If the symptoms occur less than once or twice a week, a bronchodilator may be the only medicine that is needed to control the symptoms.

Anti-Inflammatory Medicines

Cromolyn sodium and corticosteroids are anti-inflammatory medicines used in management of asthma. These reduce or reverse the swelling in the airways. These medicines also prevent the onset of swelling and therefore prevent asthma episodes. If patient gets symptoms more than once or twice a week, then anti-inflammatory medicines are also used.

Bronchodilators act principally to dilate the airways by relaxing the airway smooth muscle. They reverse and/or inhibit broncho constriction and related symptoms of acute asthma, but do not reverse airway inflammation or reduce airwav hyper responsiveness. When bronchodilators alone are not sufficient, they may sometimes cause harm, as bronchodilators relax bronchospasm and allow more allergens to enter the lungs which increase the inflammation.

Persistent inflammation causes long-term damage to the airways and leads to irreversible bronchial damage. Anti-inflammatory therapy, by keeping the inflammation in check, reduces the episodes of bronchospasm in response to provoking factors. Therefore, anti-inflammatory agents are more effective than bronchodilators for long-term control of symptoms and improvement of lung function.