Drugs Treatments for Asthma part 2

Cromolyn sodium and nedocromil sodium
These medicines reduce inflammation by preventing the activation of messages in your body that tell the immune system to start acting up. They are less effective than inhaled steroids.
Cromolyn sodium and nedocromil sodium are typically used as daily controller medications, but can also be used before exercise or exposure to an allergic asthma trigger.
Brand Name Generic Name
Intal® sodium cromoglycate
Tilade® nedocromil sodium
Long-acting beta-agonist inhaler (beta-adrenergic agonist)
This medication prevents constriction by stimulating the messages to the smooth muscles in the airways that help relax the bronchial tubes. Long-acting beta-agonists are often used as a long-term control medication in moderate persistent or severe persistent asthma, particularly to prevent symptoms for those with nighttime symptoms and/or exercise-induced asthma. They are effective for up to 12 hours and are not for use as quick-relief medication.
Brand Name Generic Name
Foradil® Formoterol
Serevent® Salmeterol
Methylxanthines
This type of oral medication is a bronchodilator. Theophylline is rarely used in asthma treatment today and is noted for significant side effects, including nervousness, hyperactivity, upset stomach, and headaches. Tell your doctor if you are taking any other medicine with theophylline because side effects may occur.
Leukotriene modifiers
Antileukotrienes, also known as leukotriene inhibitors or modifiers, are among the newest oral anti-inflammatory medications. The body processes leukotrienes, chemicals that cause inflammation, as part of the reaction to an allergen. They may be useful as a primary treatment to control mild persistent asthma or as add-on therapy with moderate or severe persistent asthma. Two of these drugs, zafirlukast (Accolate®) and montelukast (Singulair®), block the action of leukotrienes in your lungs, while a third medication in this class, Zileuton® (Zyflo®), inhibits their production. All three drugs block the recognition of allergens, thereby avoiding the usual cascade of symptoms. The result is a decrease in the frequency of asthma flare-ups and a decreased need for quick-relief medications. These medications do not benefit every asthmatic. Side effects include headache and nausea, and the medications may interact negatively with other drugs, such as blood thinners.
Brand Name Generic Name
Accolate® Zafirlukast
Zyflo® Zileuton
Singulair® Montelukast
Quick-relief medications/bronchodilators
Called quick-relievers or rescue medicine, this type of medication works quickly to relieve flare-ups of asthma symptoms. They can "rescue" you and keep symptoms from getting worse. Most of this type of medicine comes in a canister and is inhaled.
Relievers work by opening airways and increasing airflow. They will stop the coughing, chest tightness, shortness of breath and wheezing associated with an asthma attack within 30 minutes.
Quick-relief medication is not meant to be used daily. Relievers are used at the moment you are having a flare-up of symptoms. No matter how light or severe your asthma is, your doctor will make sure that you have a reliever medication available. If you are using more than one canister of this medicine each month for relief, it may indicate that your long-term control medication needs to be adjusted. The two types, or classifications, of quick-relief medication are anticholinergics and short-acting beta-agonists.
Anticholinergics
Anticholinergics relax muscles around the airways to reverse airway narrowing and stop spasms in the bronchial muscles. Inhaled anticholinergics are generally not used as a first-line reliever medication for most patients with asthma as they may take several hours to take effect. They use a different mechanism than short-acting beta-agonists to make it easier to breathe and are usually used as an adjunct to inhaled Beta2-agonists (also known as B2-agonists) in patients who have severe asthma episodes. There is now an anticholinergic and short-acting beta-agonists combination available.
Brand Name Generic Name
Atrovent® ipratropium bromide
Combivent® ipratropium bromide and albuterol
Short-acting beta-agonists
Beta2-agonists, or short-acting beta-agonists, are the most effective bronchodilators. When bronchial muscles tighten, the airway is narrowed and asthma symptoms occur. B2-agonists work rapidly and selectively on the B2 receptors in the muscles that surround the bronchial tubes to open the airways and improve breathing by reversing bronchoconstriction, allowing the muscles to relax. They also slow the release of histamines (part of the body's reaction to an allergen) and increase the body's ability to clear mucus from the airways. Their duration is about four hours. However, brands differ in potency, onset of action, and peak effective time.
B2-agonists are generally used on an as-needed basis during an asthma episode or prior to exercise for EIA. They are not intended for use every day, more than three times in any given day, or in excess of one canister per month. Excessive use indicates poor control and the need to add or increase long-term control medications. It could also mean that the inhaler isn't being used properly and the patient is not getting the proper dosage. Possible side effects are shakiness, jitteriness or rapid heartbeat, which should wear off after several weeks as the body adjusts to the medicine.
Brand Name Generic Name
Proventil®
Ventolin® Albuterol
Alupent® Metaproterenol
Maxair® Pirbuterol
Combination therapy
The first combination anti-inflammatory and bronchodilator, fluticasone propionate and salmeterol inhalation powder, (Advair®, Diskus®) became available in the United States in 2001. The drug does not replace fast-acting inhalers for sudden symptoms. This medication is a controller medication or preventative medication and like Serevent or Foradil is not to be used as a reliever medication. While adjusting to the switch, one is not as able to heal after surgery, infection or serious injury.

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