In order to keep your asthma under control, you will need to implement a number of different strategies, such as limiting your exposure to things that can set it off, keeping a journal to track your symptoms (and possibly using a peak flow metre), being aware of when to use your quick-relief inhaler and being able to properly administer it, and so on. Managing this respiratory condition also necessitates the use of long-term controller drugs for many patients, particularly those who have asthma that is difficult to control or asthma that ranges from mild to severe.
Medication used to help regulate asthma symptoms over the long term is called a controller medication. Long-term control can be achieved with a variety of drugs, each of which operates in a distinct manner to provide the desired effect.
Corticosteroids, also known as glucocorticoids, are the type of steroids that are used to treat asthma. These steroids are not the same as the anabolic steroids that are used to increase muscle mass or improve athletic performance. Inhibiting inflammatory processes and molecules is the primary function of corticosteroids. An inhaler is used to administer a dose of asthma medication directly into the tissues of the airways. Inhaled corticosteroids are one type of drug that falls under this category. When taken on a consistent basis over an extended period of time, this helps reduce inflammation, mucus production, and narrowing of the airways, all of which contribute to the difficulty that asthma patients have in breathing. It is not possible to utilise corticosteroids that are inhaled as a replacement for a rescue inhaler because they do not provide instant relief for symptoms.
Corticosteroids taken orally as well as those injected
In addition to being administered intravenously or orally, corticosteroids can also be injected. Oral corticosteroids deliver higher concentrations of the drug to the airways, which they reach through the bloodstream first. Because of this, although they are more effective therapies, they also have a greater risk of adverse effects, which is why they are only recommended for use for a limited amount of time at a time. For instance, if a person experiences a severe asthma attack, a healthcare professional may prescribe a course of these high-dose steroids to be taken over the period of one or two weeks in order to bring the symptoms of asthma under control.
Bronchodilators with a long duration of action
Drugs that reduce bronchoconstriction, or the tightening of the muscles around the airways that occurs when asthma flares up — or, to put it another way, that help open up restricted airways — are referred to as bronchodilators. Bronchodilators are also known as beta-2 antagonists. Inhalers for quick relief, which are used to alleviate the symptoms of asthma immediately, contain bronchodilators with a short duration of action. Long-acting bronchodilators are another type of medication that can be provided to patients to help prevent asthma episodes. Depending on the kind, a single dose of a long-acting bronchodilator can keep working for either 12 or 24 hours. Inhaled corticosteroids are often used in conjunction with long-acting bronchodilators, and there are many different types of inhaled asthma medicines that contain both corticosteroids and long-acting bronchodilators.
One such anti-inflammatory treatment option is called leukotriene modifiers. In order for these medications to be effective, they interfere with the activity of naturally occurring inflammatory chemicals known as leukotrienes. Leukotrienes are the major cause of bronchoconstriction and are released when an asthma attack occurs. Inflammation, bronchoconstriction, and the creation of mucus are all avoided as a result of this. Patients are instructed to take their leukotriene modifiers in the form of pills once or twice day, depending on the particular brand that has been given to them.
Mast cell stabilisers
Mast cells are responsible for the release of a wide variety of inflammatory compounds (leukotrienes, mentioned in the previous paragraph, are one example). Mast cells are essential to the regular function of the immune system; nevertheless, the activation of mast cells has been linked to a number of different health disorders, including asthma. Inhalable (using a device called a nebulizer) asthma drugs called mast cell stabilisers block mast cells from releasing inflammatory chemicals by preventing their release.
Immunoglobulin E (IgE) blockers
The action of an antibody known as IgE can be prevented from triggering an asthma attack by using this medicine, which suppresses its activity. This medication, which is administered through injection, is normally reserved for patients who suffer from severe allergic asthma.
Anti-Interleukin (anti-IL) agents
Interleukins, often known as ILs, are a collection of proteins that play an important role in the regulation of immunological responses. Some ILs have been linked to asthma, more specifically to a kind of asthma known as eosinophilic asthma. This form of asthma is frequently severe and has been linked to high amounts of eosinophils, which are a type of white blood cell. There are a number of anti-IL medicines, each of which works to lessen the severity of disease by focusing on a particular class of ILs. Injection-based treatments like this are normally reserved for patients with severe cases of asthma and are administered by medical professionals.
Anticholinergics are a category of drug that is typically prescribed for the treatment of chronic obstructive pulmonary disease (COPD), while many anticholinergics are also used as asthma controllers.
Choosing an asthma medicine to regulate your symptoms
A significant number of these drugs are typically taken in conjunction with one another. With the help of your healthcare professional, you will make the decision regarding the appropriate controller medication or combination of controller medications that will work the best for you. This decision may involve more than one prescription. Even if you are feeling OK, you should continue to take your asthma medicine as prescribed by your doctor and follow the dosing schedule even if you are not having any symptoms. This is true even if you are using a different drug to treat your asthma.