Medical Treatment of Asthma
There are various asthma medications that can be used alone or in combination with others.
There are quick relief medications that are used when a crisis occurs or asthma episode in order to obtain rapid relief although short-term. These include various bronchodilators (drugs that open airways) fast-acting. Usually these are supplied in small inhalers that the person can carry. There are attachments for the use of young children or elderly who may have difficulty using an inhaler. There are also sprays that vaporize the dose of medicine by creating a mist that the patient inhales continuously.
There are also medications long-term control. These are used continuously to control chronic symptoms and prevent asthma episodes. These include inhaled glucocorticoids. These are anti-inflammatory drugs are considered the most effective. Inhaled glucocorticoids help reduce the frequency of asthma episodes and reduce the dose of other drugs used to relieve symptoms. Because they travel directly into the airways is a risk of side effects is greatly reduced. Can still cause some problems such as thrush in the mouth and pharynx, atrophy of the muscles of the larynx which causes speech problems caused by irritation and coughing. Using low doses or a holding chamber are reduced these effects. Inhaled glucocorticoids may also affect the growth of some children. In addition there may be a slight increased risk of skin bruising and it becomes thin and susceptible to damage. The use of spacer is recommended as well as mouthwash and gargle after throwing water used. This reduces the amount of glucocorticoid that can be swallowed and absorbed through the digestive system. It also reduces the possibility of infections such as candidiasis already mentioned and the irritation of the mouth and throat.
Other drugs are long-term control beta-2 agonists. These are bronchodilators whose action can last up to 18 hours. Some of these are salmeterol (Begles Serevent INASP Betamican) and formoterol (Oxis, Neblik, Foradil). These drugs are used in combination with inhaled glucocorticoids.
The leukotriene modifiers or inhibitors are other medicines for long-term control. Leukotrienes are substances secreted by cells in the lungs during an asthma attack that cause inflammation in the lining of the airways. Some are leukotriene modifiers montelukast (Singulair) and zafirlukast (Accolate). Usually are not as effective as inhaled glucocorticoids but are an option when there is a mild attack of asthma and want to avoid the use of glucocorticoids. Leukotriene modifiers are also used in combination with inhaled corticosteroids or other medicines to help prevent asthma episodes.
The chromones – including cromolyn (Intal, Frenal) and nedocromil (Tilade, Ildor, Brionil, Cetinil), inhibit the degranulation of mast cells, immune cells that release histamine which in turn takes part in the inflammatory process. In some patients these drugs can control asthma and prevent asthma attacks of mild to moderate. In some cases they can help prevent exercise-induced asthma when used one hour before strenuous physical activity.
Methylxanthines (theophylline and aminophylline) act as bronchodilators. Its mode of action is unknown and at high doses can cause side effects such as headache, nausea, vomiting, severe abdominal pain, diarrhea, reflux, confusion, fast or irregular heartbeat, nervousness and even coma. The doses of these drugs must be tailored to each person through blood tests. Currently these drugs are falling into disuse.
Immunotherapy is another treatment. This is used for desensitization injections against allergens that can cause an asthma attack. They are administered as a vaccine the same substances that cause asthma, but in small quantities so that the body gets used and not reject them. This is a long-term therapy based on subcutaneous injections. The desired effects may take two or three years to produce.
Anti-IgE monoclonal antibodies – In allergies the body produces antibodies called IgE that attack substances that generally are harmless, like pollen, dust mites or hair from domestic animals, causing the typical symptoms of this condition . A drug called omalizumab (Xolair) blocks the action of these antibodies and thus reduces the number of episodes of asthma caused by allergies. This medicine is provided based on injections. Among the risks is the possibility of a severe reaction that can produce up to two hours after injection. It is also believed that this drug may be related to cancer development. Pregnant women should or lactating should consult their doctor and that Xolair may cause complications.