Asthma
There are two main treatments for asthma - preventers and relievers. These come in a variety of delivery devices called inhalers, which enable you to breathe the medicine in through your mouth, directly into your lungs. The addition of a spacer device increases the medication delivered to the lungs.
Preventers
Preventers are designed to quell swelling and inflammation in the airways and reduce mucus. This also reduces the sensitivity of the airways and so minimises potential damage.
The protective effect is built up gradually over a period of about a fortnight. Your medication must be taken daily to maintain protection, even if you are not experiencing symptoms.
Most preventers are based on corticosteroids, usually known as steroids. These are completely different from the anabolic steroids sometimes used by bodybuilders and athletes.
Most common types of preventer are inhaled steroids. These can include beclomethasone, budesonide, fluticasone.
There are other non-steroid preventers, usually used for children, such as sodium cromoglycate and nedocromil sodium. They are usually taken three to four times a day and are not generally as effective as steroids.
Many people worry about the side-effects of steroids. High doses of steroids taken over a long period can have significant side-effects. For this reason, doctors will be careful to prescribe the lowest possible dose needed to control your asthma.
Potential side-effects of preventers
The main side effects are hoarseness and an increased risk of mouth and throat infections caused by thrush, a yeast that lives normally on the body's mucous membranes.
Using the inhaler before brushing your teeth and rinsing your mouth out afterwards helps to avoid this. Using a 'spacer' makes it easier to inhale the drug, and so helps reduce the risks of steroids being absorbed into your body.
Relievers
Relievers are drugs that relax and open up the airways - medically known as bronchodilators - making it easier to breath. These are prescribed for the relief of asthma symptoms during an actual asthma attack, when peak flow readings are low and before exercise or activity to reduce the risk of an attack.
Because these drugs do not reduce swelling and inflammation of airways, you may also need to take a preventer.
Some relievers alleviate symptoms almost instantly (rescue relievers). Others have a longer lasting action (long-lasting relievers). The latter may be prescribed if wheezing, breathing difficulties and coughing persist despite using a preventer and a rescue reliever - or if symptoms come on in the night - nocturnal asthma.
Common rescue relievers are salbutamol and terbutaline. Another type of reliever (most often prescribed for babies under two and for older people) is called ipratropium bromide.
Long-lasting relievers include oxitropium, salmeterol, and eformoterol, all of which are inhaled. Occasionally, theophylline-based drugs are taken by mouth, so tablets may be prescribed.
Potential side-effects of relievers
Side effects are usually mild and pass away quickly. The main ones are a slightly increased heartbeat, and muscle trembling, especially in the hands. Some oral relievers may cause dry mouth, blurred vision, difficulties passing urine, or constipation.
Theophylline-based drugs can occasionally cause nausea, more rapid heart rate, a nettle-like rash, dizziness, nervousness, headaches, irritability or restlessness.
Always report any unusual symptoms to your doctor.
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