Family Health Guide

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Asthma: Medication

The most common types of asthma medications are long-term medications that help get chronic airway inflammation under control, and short-term medications that bring relief during an attack.

Medications are given in pill, liquid and inhaled form. Because kids often let medication escape from an inhaler, your doctor may advise you to use a nebulizer, an electrical machine that converts meds into a mist that is inhaled through a face mask. Inhaled meds work quickly and produce fewer side effects.  Nebulizers can deliver larger doses of asthma meds than other devices, although more slowly, and need to be administered more frequently. Some children can get a quicker fix by using a spacer, a hollow tube that attaches to a metered dose inhaler to ensure your child’s medication makes it into his mouth and lungs. Medication in pill form may be used once a child is able to swallow them.

Short Term Medications

Bronchodilator inhalers (albuterol (Ventolin, Proventil), levalbuterol (Xopenex)

These drugs instantly open airways during an attack, but unless your child suffers from exercise-induced asthma, they should not be used daily. If your child uses her rescue inhaler more than twice a week, her asthma is not under control.

Long Term Medications

Inhaled corticosteroids (Azmacort, Vanceril, AeroBid, Flovent, Pulmicort, Asmanex, Respules)

These are the first line of treatment for asthma because they reduce inflammation over the long term. About two thirds of children with either intermittent or chronic asthma have good control over it using an inhaled steroid once a day. Children who have seasonal asthma due to allergies or colds also have good success using these drugs during their high-risk seasons, although they might take a while to kick in.

Side Effects: Mild side effects can include upset stomach, oral thrush and body aches. Over the long term, steroids may slow a child’s annual growth rate, although this is thought to be reversible if the child stops taking the medication.

Leukotrien modifiers (Singulair, Zyflo, or Accolate)

Anti-leukotriens can block chemicals that contribute to airway spasms and swelling, and reduce mucus production. They’re often prescribed if corticosteroids alone aren’t sufficiently controlling asthma.

Side Effects: Although most side effects are mild, like cough, upset stomach and ear pain, in rare cases these drugs have been linked to behavior and mood changes, including hallucinations and suicidal thinking.

Combination inhalers (Advair, Symbicort)

These combine corticosteroids plus a long-acting beta agonist (LABA), which relax airway muscles. LABA medications should only be used when combined with inhaled corticosteroids. The use of LABAs alone has been link to worsening of asthma symptoms.

Cromolyn sodium (Intal)
This anti-inflammatory non-steroid medication may help prevent mild to moderate bronchial asthma attacks. Cromolyn needs to be taken two to four times a day; it can be taken along with an inhaled corticosteroid, sometimes helping to reduce usage of other meds and even phasing them out. It may take up to four weeks to be effective. 

Side Effects: Throat irritation, headache, bad taste, cough and stuffy nose.