While there are many effective medications for asthma, they can be divided into two general categories: anti-inflammatory and rescue medications.
Like the name implies, anti-inflammatory medications help control the inflammation of the tissues in the lungs. Drugs like prednisone and Flovent® (fluticasone propionate) are corticosteroids. Although very effective, the oral forms of these can have serious side effects associated with long-term use. They may include weight gain, anxiety or sleep problems, and changes in eating habits.
There are non-steroidal anti-inflammatory medications like cromolyn sodium, commonly known by the trade name Intal®. Unfortunately, they are not always effective for adults or older children.
The second class of medications used in the treatment of asthma is the rescue inhaler, or bronchodilator. During an asthma attack, these short-acting medications dilate or open the airways, temporarily restoring normal breathing. Although comfortable breathing may be restored, the continuing inflammation remains, putting the patient at risk for another asthma attack.
Perhaps the most common of these bronchodilators is albuterol or Ventolin®. It is generally considered safe, although it can cause excitability, especially in young children. However, using an albuterol inhaler 10 or more times a day can have serious consequences.
For this reason, it is important for patients to work with their doctors to find a treatment plan that effectively controls the underlying inflammation. Controlling the inflammation relieves the dependence on rescue medications, though you "shouldn't leave home without them."
Although anti-inflammatory medications and bronchodilators perform different functions, their delivery systems overlap. Patients can take either type of medication orally, in liquid or pill form. Each type can also be inhaled with a pocket inhaler (puffer) or with a nebulizer.
Pocket inhalers use a propellant like chlorofluorocarbons (CFCs) to mist the medication so the patient can breathe it in. A nebulizer forces compressed air over the liquid medication to produce the same misting action.
Inhaling brings the medication directly to the airways, where it's needed. Because of this direct delivery system, the body absorbs less medication, reducing some of the side effects. In some cases, though, the side effects are different. For example, inhaled use of corticosteroids can cause yeast infections in the mouth and increased eye pressure. The oral form, liquid or pill, can cause weight gain, facial hair growth and acne.
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