Asthma medication is generally administered by means of what is called an inhaler, of which there are two main types: Relievers and Preventers
Relievers:
These inhalers, usually blue in color, are the first line of defence to an asthmatic attack immediately as symptoms appear. Principal medications include Salbutamol Ventolin, which is the most popular, and terbutaline (Bricanvl). These medications are what are called anti-spasmodic and act to relax the smooth muscle of the airways. In turn this has an immediate effect and hence are often referred to as ‘rescue relievers’.
- To get more technical:
Short acting beta2-adrenoceptor agonists (SABA), such as salbutamol (albuterol USAN) are the first line treatment for asthma symptoms.
Anticholinergic medications, of which ipratropium bromide is one, provide added benefit when jointly used with SABA when medium to severe asthmatic symptoms are present. Anticholinergic bronchodilators can be great as may also be used if a person cannot tolerate a SABA.
In the past, more general adrenergic agonists, such as inhaled epinephrine, have similar efficacy to SABAs. They are however not recommended due to concerns regarding excessive cardiac activation.
Preventers:
Preventers are the second type of inhaler asthma medication and are white, red, brown or orange in color. Their purpose is to protect the lining of the airways by decreasing the swelling and inflammation of the mucusmembrane and reducing their sensitivity to allergens. These asthma medication inhalers are usually used in both the morning and evenings, even when no symptoms are present. They do not have an immediate effect but act over a chronic period of regular usage.
- To get more technical, flutcasone propionate metered dose inhaler are commonly used for long term management of asthma.
More specifically, it has been shown that glucocorticoids are the most effective treatment available for long term control. The only times this would not be administered though an inhaled form would be if the asthma was at a severe persistent form, in which case oral steroids may be needed. In general, inhaled formulations may be taken once or twice a day, depending on which degree symptoms are present.
Another type of medication called Long Acting Beta-Adrenoceptor agonists (LABA) have at least a 12-hour effect. However, they are not to be used without a steroid as there is a chance of increased risk of severe symptoms. These medications have received much attention from a safety standpoint. For example, in December 2008, members of the FDA’s drug-safety office recommended withdrawing approval for these medications in children. Discussion is ongoing about their use in adults.
Leukotriene antagonists (for example: zafirlukast) are an alternative to inhaled glucocorticoids, yet are not preferred. They may also be used in addition to inhaled glucocorticoids but in this role are viewed second line to LABA.
In addition, mast cell stabilizers (cromolyn sodium for example) are another non-preferred alternative to glucocorticoids.