Short-acting rescue medicines are used to treat acute asthma symptoms.
Children will be more likely to benefit from inhaled medicines if a spacer is used with
metered-dose asthma inhalers. The
University of Arizona
offers a table that compares the different brands of spacers. A study, though, found that there was no difference in how medicine was delivered with homemade versus store-bought spacers. Talk to your doctor to find out what is right for you or your child.
Common names of beta-2-agonists (inhalers) include:
- Albuterol
(Proventil, Ventolin)
- Levalbuterol
(Xopenex MDI)
- Pirbuterol
(Maxair)
These drugs are bronchodilators, meaning they open the airways by relaxing the muscles around bronchial tubes. This can provide quick relief of acute symptoms. They can also be used as preventive medicines prior to exercise.
You must be careful not to overuse these drugs and contact your doctor immediately if your symptoms are not controlled.
Common side effects include:
- Fast heartbeat
- Headache
- Nervousness
- Tremor
Ipratropium
is a bronchodilator. This is a type of medicine that opens up narrowed breathing passages and may decrease mucus secretion.
Tiotropium, a closely related medicine, has also been studied for use in patients with asthma. These medicines are taken by inhalation to help control the symptoms of lung diseases, particularly
chronic bronchitis, and
emphysema. Ipratropium and tiotropium help decrease coughing, wheezing, shortness of breath, and troubled breathing by increasing the flow of air into the lungs.
When ipratropium inhalation is used to treat acute, severe attacks of asthma, bronchitis, or emphysema, it is usually used in combination with other bronchodilators. While these drugs are not commonly used to treat asthma except in the emergency room setting, there is some evidence that tiotropium can reduce the need for oral or inhaled corticosteroids in people with very severe and persistent asthma.
Common side effects include:
- Cough
- Dryness of mouth
- Unpleasant taste
Common names include:
- Methylprednisolone
- Prednisone
- Prednisolone
These drugs are sometimes used for a short duration to prevent the progression of moderate or severe symptoms, reverse inflammation, speed recovery, and reduce the risk of relapse. They are not truly rescue medicines, but help prolong the effect of beta-2 agonist rescue.
Possible side effects include:
- Indigestion
- Lowered resistance to infections
- Abnormalities in glucose metabolism
- Increased appetite
- Mood alteration
- Fluid retention
Long-term “control” medicines are used to achieve and maintain long-term management of symptoms and reduce inflammation.
Common names include:
- Beclomethasone
(Beclovent, Vanceril, Qvar)
- Budesonide
(Pulmicort)
- Flunisolide
(Aerobid)
- Fluticasone
(Flovent)
- Mometasone
These drugs suppress, control, and reverse inflammation. They can reduce the need for oral corticosteroids and play a role in the long-term management of asthma.
Possible side effects include:
Common names include:
- Methylprednisolone (Medrol)
- Prednisolone
(Pediapred, Orapred)
- Prednisone (Deltasone, Orasone)
These drugs help reduce inflammation and prevent escalation of symptoms. Oral corticosteroids can produce more side effects than inhaled corticosteroids. Long-term use of oral corticosteroids is not generally recommended. However, your doctor may prescribe oral corticosteroids for long durations only when other treatments have failed to restore normal lung function and the risks of uncontrolled asthma are greater than the side effects of the medicine.
Possible side effects include:
- Indigestion, nausea, and possibly bleeding in the stomach
- Lowered resistance to infections
- Growth suppression (in children)
- Obesity
- Diabetes mellitus
- Hypertension
(high blood pressure)
- Osteoporosis
(thinning of the bones)
- Cataracts
- Adrenal suppression
- Muscle weakness
Common names include:
- Cromolyn sodium
(Intal)
- Nedocromil
(Tilade)
These drugs are occasionally used for long-term prevention of symptoms. They may modify inflammation and can be used as preventive treatment prior to exercise.
Possible side effects include:
Common names include:
- Salmeterol
(Serevent)
- Formoterol
(Foradil)
These drugs provide long-term prevention of symptoms, especially nighttime symptoms and are often added to anti-inflammatory therapy such as inhaled corticosteroids. They may also be used as preventive treatment prior to exercise or contact with a known allergen. However, they should not be used during an acute attack.
Possible side effects include:
- Rapid heart beat
- Tremor
- Difficulty sleeping, nervousness
Long-acting inhalers, like salmeterol, may increase the risk of asthma-related death, intubation (putting a tube in the windpipe to breathe), and hospitalization.
These medicines are almost always prescribed together with an inhaled corticosteroid.
Note: If you have any concerns, talk to your doctor.
Common names include:
- Theophylline
(Theo-Dur, Uniphyl, Slo-bid)
This type of drug provides long-term control and prevention of symptoms, especially nighttime symptoms. It works by opening the airways and relaxing the muscles around the bronchial tubes. It also increases the ability to clear mucus out of the airway.
Possible side effects include:
- Headache
- Fast heartbeat
- Difficulty with urination
- Nervousness
- Trouble sleeping
- Upset stomach
- Zafirlukast
(Accolate)
- Montelukast
(Singulair)
- Zileuton—used for long-term control and prevention in mild persistent asthma. Blocks the production of leukotrienes. Possible side effects include elevation of liver enzymes and interactions with other medicines
Leukotriene inhibitors are medicines that decrease inflammation by preventing the action of leukotrienes. These types of medicines are not used to relieve acute symptoms, but can be used to prevent your symptoms from occurring.
Possible side effects include:
- Flu-like symptoms
- Nervousness, excitability
- Headache
- Stomach pain
- Cough
Common names include:
-
Omalizumab—used for long-term control and prevention of moderate or persistent allergic asthma. Binds to IgE. This medicine is injected. Pain and bruising at the injection site may occur.
Anaphylaxis
has been reported.
These drugs provide long-term control and prevention of symptoms in mild, persistent asthma. They work by blocking the action of leukotrienes—chemicals that play a role in inflammation and allergic reactions.
Possible side effects include:
- Rapid heart beat
- Tremor
- Difficulty sleeping, nervousness
Combination Drugs
Common names include:
- Fluticasone and salmeterol
(Advair)
- Budesonide and formoterol (Symbicort)
These drugs provide long-term control and prevention of symptoms by combining the effects of a long-acting beta-2-agonist and inhaled steroid into one formulation (which makes dosing more convenient).
The side effects are similar to those described above for the individual medicines.