health

Besides avoiding exposure to asthma triggers, asthma is mostly treated
with medicines. There are two characteristics of asthma: inflammation
and spasms (or constriction) of the muscles in the airways. Asthma
treatment focuses on both. Asthma medicines fall into two groups: those
used to prevent symptoms and control the disease for a long time, and
those that give short-term relief during an asthma attack. Taking the right
medicine at the right time is important.

Long-term control medicines Long-term control medicines are
taken every day to help prevent symptoms from starting. It may take several
weeks for these medicines to produce their best results, though. The
most effective ones work by reducing swelling in the airways. Many are
inhaled (breathed into the lungs). Not everyone needs such medicines.
However, they may be very helpful for people who have daytime asthma
symptoms three or more times per week or nighttime symptoms three
or more times per month. Medicines for long-term control of asthma
include the following:

• Inhaled corticosteroids* (kor-ti-ko-STER-oids). These strong drugs
  prevent and reduce swelling in the airways. They also make the airways
  less sensitive to triggers. However, they work only if they are
  used regularly. These drugs are taken every day by people with longlasting
  asthma. They are not the same as the unsafe steroids some
  athletes use to build muscles.
  
• Other inhaled drugs. These medications also help prevent and reduce
  swelling in the airways and make the airways less sensitive. However,
  it can take four to six weeks of regular use before they start to work.
  These drugs are taken every day by people with long-term asthma,
  but they can also be used before exercise or contact with a trigger.
  
• Oral corticosteroids. These drugs are taken by mouth in pill or liquid
  form. Unlike inhaled corticosteroids, they sometimes cause serious
  side effects when used for a long time. However, they can often
  be used safely for a short time to treat severe asthma attacks and to
  quickly bring asthma under control. They are sometimes taken every
  day or every other day by people with the most severe asthma.
  
• Long-acting bronchodilators (brong-ko-DY-lay-tors). These drugs
  relax the muscles around the airways, making breathing easier. They
  can prevent or reduce narrowing of the airways. However, they keep
  working only if they are used regularly. These drugs are inhaled or
  taken by mouth in a pill. Some are especially useful for preventing
  nighttime or exercise-related asthma.
  
• Inhaled anticholinergics (AN-tih-ko-lin-ER-jek). This medicine
  is a type of bronchodilator. It relaxes the muscles around the airways,
  making breathing easier. The medicine takes about an hour
  to work, so it should not when quick relief is needed. The drug can
  be breathed in using an inhaler or nebulizer. It works best when
  taken with a short-acting bronchodilator; however, it is not commonly
  used to treat asthma.
• Leukotriene modifiers (loo-ko-TRY-een). These drugs prevent and
  reduce swelling in the airways and make the airways less sensitive to triggers. They also prevent squeezing of the muscles around the
  airways. These drugs are taken regularly by mouth in a pill.
• Anti-IgE therapy. This is a newer type of medicine that blocks
  the substances in the blood that cause allergy-related asthma symptoms.
  The drug is for people who have moderate to severe asthma
  symptoms that continue despite other treatments. In the early
  2000s, anti-IgE therapy was only approved for persons age 12 and
  older. It is given by injection.
  
• Allergy vaccines. In some cases, a person’s asthma symptoms can
  be prevented or lessened if the individual takes a course of special
  allergy injections over months or years. These shots contain
  small amounts of the allergens that trigger the person’s asthma. The
  course of injections causes the person to become less sensitive to
  the allergen when exposed to it.

Short-term relief medicines Short-term relief medicines are taken
only when needed to relax and open the airways quickly. They can be used
to relieve symptoms or to prevent them if a person’s peak flow meter readings
begin to drop, signaling an upcoming asthma attack. However, the
effects last for only a few hours. They cannot keep the symptoms from coming
back the way long-term control medicines can. These drugs are inhaled
and are taken at the first sign of trouble or before contact with a trigger.
Medicines that provide short-term relief of asthma are called shortacting
bronchodilators. These drugs relax the muscles around the airways,
making breathing easier. They begin to work within five minutes, and
their effects last for four to six hours. Such drugs are taken right after
symptoms start or just before exercise.

How Are Inhaled Medicines Taken?
Many asthma medicines are made to be breathed into the lungs. Such inhaled
drugs go straight to the place where they are needed. The most popular
device for taking inhaled medicines is a metered dose inhaler, which gets the
drug to the lungs in exact amounts. The inhaler is a small, hand-held canister
with a button that the person pushes to make the medicine spray out. Often
a tube, called a spacer, is attached to the canister to make it easier to use.
Another type of device that is sometimes used to take inhaled medicines
is a nebulizer (NEB-you-lyz-er), which turns liquid medicine into a
very fine mist. These devices are helpful for babies, young children, and
elderly or very sick adults who would have trouble handling a metered
dose inhaler.