Drugs for asthma

In asthma, the trachea contractes and it becomes difficult to breathe. The treatment consists, among other things, of different types of drugs that you inhale, called inhalation. You often need to use both cortisone and drugs that widen the trachea.

There are various drugs that you can use for asthma. They work in different ways and are often combined for the best possible effect.

Objectives of drug treatment

There are several goals with the treatment:

  • You should get rid of long-term asthma problems that make you feel less or sleep less.
  • You should not have any problems with asthma in everyday life.
  • Treatment should reduce the risk of asthma attacks.
  • You should quickly get better if you have an asthma attack.
  • Your lungs should function as well as possible in the future.

What is Asthma?

Asthma is due to inflammation in the mucous membranes of the trachea, which makes the trachea extra sensitive to certain things. For example, it can be pollen, mites, cold air and strong scents.

Asthma is a lifelong disease and you may therefore need to take medication for a long time to keep the symptoms under control. Otherwise, there is a risk that asthma will worsen and cause severe asthma attacks.

Medication for asthma in children

Asthma in children is treated with the same drug as adults, but at lower doses. The dosages and drugs that the child needs depend on the child’s age and how much asthma symptoms they have.

Treatment for cold asthma

Children can get a particular type of asthma when they are cold, called cold asthma or infectious asthma. This form of asthma is because children’s lungs are not fully developed.

Cold asthma is not a lifelong disease and the child usually only needs to take medication during the days when it is cold. The risk of having a cold asthma decreases as the child gets older and disappears completely when the child is about six to seven years.

The treatment usually consists of the child being allowed to inhale short-acting drugs that widen the trachea. It makes it easier to breathe, but the drug does not affect the infection itself.

The child may also need to be treated with cortisone and long-acting bronchodilator medication for an extended period of time if the symptoms are more severe or frequent.

Medicines used in asthma

The drugs used in asthma can be divided into different groups depending on how they work. Which drugs you receive will depend on your inconvenience.

These are examples of different types of drugs used to treat asthma:

Respiratory widening drug

These drugs widen the trachea by relaxing the muscles in the trachea. The drugs are used daily to prevent asthma problems and in case of asthma attacks. They are also called beta-2 stimulators.

cortisone Cortisone suppresses inflammation of the trachea and heals irritated tissue. For most people with asthma, it is good to inhale cortisone regularly. You need to inhale cortisone every day for a few weeks to get full effect.

Leukotriene inhibitors
This kind of drug blocks some inflammatory reactions in the airways. The drug does not help with acute asthma problems, but is used every day for preventative purposes.

Other medicines for asthma
In this group, for example, there are anti-bronchodilator anticholinergic drugs, chromoglycates and theophyllines.

This text does not address cough medicines, neither expectorant nor other varieties. Antihistamines found in allergy tablets will also not be described. None of these drugs are counted as asthma drugs.

Combination Drugs

There are some drugs that contain two different types of asthma drugs, most commonly bronchodilator and cortisone powder. You will thus receive both medicines at the same time when you take such a combination drug.

Combination drugs can be suitable for both children and adults who need the same medication and the same dosage every day. It is also good if you have easy to forget your medicines.

This is how medicines are used for asthma

The symptoms of asthma can vary widely. Some are trouble free for long periods, while others have constant problems despite treatment. It depends on your inconvenience how much and which drugs you need to use.

Make sure you get a treatment plan from your doctor. There it should say what to do if you get more trouble from your asthma. It is good to know how to adjust the medication if, for example, you get an airway infection or if you have increased problems during the pollen season.

Treatment for temporary asthma problems

If you have problems on a few occasions, it may suffice with short-acting, bronchodilator drugs when you have problems. You inhale the drugs. Short-acting means that the drugs have a fast effect and that the effect does not last that long.

You should use anti-inflammatory drugs regularly if you need to take short-acting bronchodilator medication more than twice a week. This also applies if the problems are mild. You usually use cortisone that you breathe in.

There are other treatment options if you continue to have asthma problems, even though you inhale cortisone every day.

Treatment for mild asthma problems

For mild asthma problems, you have often had good days for several consecutive days, and asthma is not that difficult. During these periods, you can take short-acting, bronchodilator medication several times. You can also increase the amount of cortisone you breathe.

Talk to your doctor about how to use your medicines, preferably in advance so that you know how to do if you get more trouble.

Treatment for moderate asthma problems

Moderate asthma problems may come after a period when you have had more problems with your asthma. It can feel heavy in the chest as you breathe and the drugs do not help as well as they usually do. Even during these periods, you can take short-acting bronchodilator medication several times. You should also increase the cortisone dose and you may sometimes need to take cortisone tablets.

Talk to your doctor to discuss whether you need to change your medication.

Treatment in difficult asthma problems and acute exacerbations

In severe asthma problems it is difficult to lie down and you have difficulty breathing. The trouble can be worse when you cough or talk, and it feels like the drug is not helping at all.

Anyone with asthma can have acute asthma, ie an asthma attack. You can often cope with the problems of asthma at home, but you may need to go to an emergency room in a hospital to receive treatment.

At the hospital, you can breathe in bronchodilator medication. You can also get medicine with the aid of a syringe if the inhalations are not effective. You also get more cortisone in tablet form. If you get too little oxygen, you get oxygen. You are usually allowed to stay until the attack has released. It can take from a few hours up to a day.

You need to consult your doctor to find out what caused you to have the asthma attack.

Always carry your medicines with asthma. Ask your doctor or nurse if you are unsure which medicine to take in an asthma attack.

How do I take medicines for asthma?

In asthma, drugs are mainly used in the form of spray and powder that you breathe in, so-called inhalation.

You inhale the drugs using an inhaler, either with a spray inhaler or with a powder inhaler. It is important to use the inhaler properly for you to get the medicine. Train with your asthma nurse if you are unsure how to do it.

A child can start using powder inhalers when they can handle it themselves, at about five to six years of age, but it is important to continue to control how the child uses their inhaler.

Aids to inhale the drugs

There are various aids for children who find it difficult to use an inhaler and to inhale their medications. The tools are also good for adults who have difficulty using inhalers.

spacer

With a breathing container, the child can inhale the drug at his own pace. Another name for breathing tanks is the spacer.

The breathing container consists of a small tube with a breathing mask at one end that an adult puts over the child’s mouth and nose. At the other end of the tube is placed a spray container with the drug. When you or the child give a push of the drug it ends up in the tube, and the child can then calmly inhale the drug through the respirator.

The respirator is used for asthma drugs that are in spray form.

nebulizer

Nebulizer is a tool for inhaling drug fluids. The nebulizer atomizes the liquid into steam that the baby can breathe. It can be used if the child has difficulty in inhaling otherwise.

A doctor or asthma nurse can prescribe a breathing container or nebulizer as an aid.

Important to help children with treatment

Children may need the help of an adult to take their medicine, whether the child is using an inhaler, a breathing container or a nebulizer. A doctor or asthma nurse can show how the tools should be used.

It is important that both the child and the adult or adults who help the child learn how to handle the drugs, so that the children receive the drugs.

Pregnancy

It is important that you feel as good as possible if you are pregnant. Therefore, you should continue to take your medicines so that you have as little asthma as possible. There is a greater risk that the child will be harmed by the fact that you who are pregnant have a poorly treated asthma, than by drugs.

Talk to your doctor if you are planning to become pregnant or if you are pregnant. Do not increase or decrease your medication without first talking to your doctor.

Respiratory widening drug

Respiratory widening drugs interrupt the muscle spasm in the airways, so that the muscles relax and the trachea dilates. Then it becomes easier to breathe. Almost everyone who has asthma uses any drug from this group.

Respiratory widening drugs almost always have an effect, but they do not affect the inflammation found in the airways. Therefore, bronchodilator drugs should only be used as the only treatment if you have very mild asthma problems, or if you have occasional complaints.

Respiratory widening drugs are available as both short-acting and long-acting drugs.

Here is described bronchodilator drug from the beta-2 stimulant group. Later in the text you can read about anticholinergic drugs, which is another type of bronchodilator drug.

Short-acting bronchodilator drug

The short-acting, bronchodilator drugs are best for severe, sudden problems. When you take the drug, the muscle spasm in the trachea breaks within minutes. The effect lasts for up to six hours.

Short-acting bronchodilator drugs are also used in cold asthma in children, during the days the child is cold. The drug can also be used to avoid having an asthma attack, for example before exercising or doing anything else strenuous.

Children of all ages can use the fast-acting, bronchodilator drugs.

Long-acting bronchodilator drug

Long-acting, bronchodilator drugs provide long-lasting effect, up to 12 hours. This is useful if you have nighttime problems or if you feel your asthma several times during the day. There are also ultra-long-lasting bronchodilator drugs that last for 24 hours. These are currently only available in combination with cortisone and can be used by adults and children over 12 years.

The long-acting drugs are better suited for everyday problems that are not so great. The drug is not recommended for children under 4 years. This is because the effect and safety of the drugs on children of that age have not been studied.

The drugs can be used for a long time

Respiratory widening drugs can be used throughout life with good effect.

The medicines are good to use if you are pregnant.

Adrenaline

Adrenaline expands the trachea, but also affects the heart so that it beats faster and more intensively.

You can get a syringe with adrenaline in a hospital or in a health care center if you have acute, severe asthma. If you have very severe allergies, you can sometimes get adrenaline syringes prescribed by your doctor so you can always have them with you.

Important about bronchodilator medication

You should use a short-acting asthma drug containing terbutaline or salbutamol if you have an asthma attack. This is because the effect comes quickly with the short-acting asthma drugs. Terbutaline is found in Bricanyl and salbutamol is found in Ventoline, among others.

Respiratory widening drugs from the beta-2-stimulator group primarily have effects on the muscles of the trachea, but they can sometimes also affect the heart. If you have a serious heart disease, these drugs can further increase the effort of the heart. Likewise, bronchodilator drugs can make the situation worse if you have severe poisoning trauma.

Side effects

The most common side effects of these drugs are because the drug affects different muscles of the body. The side effects may feel a bit unpleasant, but they go over. These are the most common side effects:

  • palpitation
  • muscle tremors
  • that you are feeling dumb
  • headache
  • muscle spasm in the arms, legs and fingers.

It may be good to change your medication if you get any trouble every time you take it. Talk to your doctor.

Examples of bronchodilator drugs

These are examples of short-acting, bronchodilator drugs:

  • Airomir
  • Bricanyl solution for nebulizer, Bricanyl tablets and Bricanyl Turbohaler
  • Buventol Easyhaler
  • salbutamol
  • Ventilastin Novolizer
  • Ventoline Discus, Ventoline Evohaler, Ventoline in liquid form, Ventoline tablets and Ventoline, solution for nebulizer

These are examples of long-acting, bronchodilator drugs:

  • Formatris Novolizer
  • Oxis Turbuhaler
  • Serevent Discus and Serevent Evohaler

Alpha and beta stimulators

  • Adrenaline Mylan
  • Ephedrine Mylan

Combining Mediterranean

  • Combivent
  • Flutiform
  • Fostair
  • Relvar Ellipta
  • Seretide Diskus, Seretide Diskus mite, Seretide Diskus forte
  • Seretide Evohaler, Seretide Evohaler mite, Seretide Evohaler forte
  • Symbicort Turbohaler, Symbicort mite Turbuhaler, Symbicort forte Turbuhaler

Cortisone

Cortisone suppresses inflammation of the airways and heals damaged tissue. You should inhale the cortisone every day for a longer period to get a good effect. Cortisone can be used for several years without the effect diminishing. For most people with asthma, it is good to inhale cortisone regularly.

Cortisone is available as both powder and spray as you breathe. It is also available as a solution for nebulizer. If you have severe asthma worsening, you may need to take cortisone as tablets for a period of time.

Keep breathing in cortisone, even if you feel good. The risk is otherwise that you will get back the inflammation in the airways and thus the asthma problems. Always talk to your doctor if you are unsure about your medication.

The full name of these drugs is glucocorticosteroids, but they are usually called cortisone or steroids only.

Side effects

Most people inhale cortisone as a powder or spray and the cortisone then falls directly into the trachea.

Cortisone that you breathe in gives almost no side effects in the body. On the other hand, you may have some cortical discomfort that stays in your mouth. For example, it may be one or more of these problems:

  • You’re getting hoarse.
  • You get to sweat on your tongue and mouth.
  • You get a fungus in your mouth. Then it may look a little red, often on the tongue or in the palate.

To reduce the risk of side effects in your mouth, rinse your mouth with water or brush your tongue with a soft toothbrush after inhaling the cortisone. Contact a doctor if you still get symptoms of fungal in your mouth.

Long-term treatment with cortisone tablets can weaken the skeleton and make your skin thin and brittle. Therefore, you should always strictly follow the instructions given to you by your doctor.

Cortisone can affect how children grow. Children who regularly inhale cortisone may come to care and are measured one to two times a year.

Examples of cortisone drugs

Cortisone you breathe in:

  • Aerobec Autohaler
  • Alvesco
  • Asmanex Twisthaler
  • Beclomet Easyhaler
  • Budesonide Teva Pharma
  • Fluticasone Cipla
  • Flutide Discus and Flutide Evohaler
  • Giona Easyhaler
  • Novopulmon Novolizer
  • Pulmicort solution for nebulizer and Pulmicort

Combining Mediterranean

  • Airflusal Forspiro
  • Bufomix Easyhaler
  • DuoResp Spiromax
  • Flutiform
  • Fostair
  • Relvar Ellipta
  • Salmeterol/Fluticasone Cipla
  • Seretide Diskus, Seretide Diskus mite, Seretide Diskus forte
  • Seretide Evohaler, Seretide Evohaler mite, Seretide Evohaler forte
  • Symbicort Turbohaler, Symbicort mite Turbuhaler, Symbicort forte Turbuhaler

Cortisone Tablets

  • Cortisone
  • Deltison
  • prednisolone

Leukotriene inhibitors

Leukotrienes are substances that contribute to asthma inflammation. The substances trigger inflammatory reactions, including in the trachea. Drugs in the antileukotrienes group block some of these reactions.

The drugs do not help in acute asthma but are used to avoid asthma problems. Antileukotrienes are also not as effective as cortisone, but are used as add-ons to your other treatment.

About half of the people with asthma benefit from these drugs.

How do I take antileukotrienes?

You take these drugs as tablets. It is not possible to inhale antileukotrienes. The drug is also available as a powder, which you can, for example, sprinkle on the food. It is good if you are to give the medicine to a child, or if you have difficulty swallowing tablets. The drug is also available in the form of a chewable tablet.

Pregnancy and antileukotrienes

You should not start antileukotrien treatment if you are pregnant. However, you may continue to use this medicine if you have used it before you became pregnant. You may start with antileukotrienes if your asthma gets worse during pregnancy. Talk to your doctor about your asthma treatment if you are planning to become or pregnant.

Side effects

You may have headaches or coughs of antileukotrienes.

Examples of antileukotrienes

  • Singulair
  • Montelukast.

Other asthma drugs

There are other types of asthma drugs, such as anticholinergic drugs, chromoglycates and theophyllines.

This is how anticholinergic drugs work

Anti-cholinergic drugs that you breathe in cause the muscle spasm that arises in the trachea during asthma. It can be a good option if you have difficulty tolerating other bronchodilators because of side effects. It is most common to use the drugs regularly to prevent your asthma from getting worse, but they also help in the case of an asthma attack.

You can use the same dose for a long time, and if you temporarily get worse, the dose can be increased.

These drugs do not work as quickly as the other bronchodilators.

Important about anticholinergic drugs

Anticholinergic drugs also affect nerve signals in other parts of the body and can cause side effects. If you have prostate enlargement and use larger amounts of anticholinergic drugs, it may be extra difficult to urinate.

Side effects

You may get dry in the mouth by anticholinergic drugs. A few people who try the drugs can get headaches and some find it difficult to focus their eyes. This is because the lens of the eye can be affected by the drug so that it does not have the time to switch between looking up close and far as quickly as usual. It will pass. Mostly you get mild side effects from anticholinergic drugs.

Examples of anticholinergic drugs

  • Atrovent
  • Ipraxa
  • SPIRIVA

Examples of combination agents

  • Combivent
  • Ipramol
  • Sapimol
  • Ipratropium/Salbutamol
  • Salipra

This is how chromoglycates work

Chromoglycate has an effect on the muscle spasms of the trachea caused by exertion, cold air and substances that can cause an allergic reaction. It is not clear how chromoglycate works, but probably the drug prevents some cells in the blood from triggering an allergic reaction.

Convulsions in the trachea can be prevented if you take a dose before doing anything that can cause a reaction. For example, it may be before you exercise, before staying in cold air, or in an environment that can impair asthma. Take the medicine a few hours before you can prevent asthma problems. The drug is not effective enough to be used in case of emergency.

If you are pregnant, you can use chromoglycate, and even children can use it.

These drugs have almost no side effects. Some people may experience mild irritation of the throat or cough.

Example of chromoglycate

  • Lomudal for inhalation

This is how theophyllines work

Theophylline causes the muscle spasm in the trachea to temporarily release. They can be used to treat severe acute asthma, especially if other medicines have not produced an effect. You get theophylline in hospital.

Theophylline can be used if you are pregnant, and children and the elderly can use it too.

Side effects

Theophylline can have one or more of the following side effects:

  • You may feel bad.
  • You can lose your appetite
  • You may have trouble sleeping.
  • You can get headaches.
  • You may get disturbed heart rhythm.

Some children may become overactive or worried.

The side effects are related to how much medicine you have in your blood. Therefore, you should regularly check that the amount of medication is adequate. Your doctor is responsible for this, and you are usually allowed to have a blood test when you return.

There is a risk that the drugs will interact if you take theophylline at the same time with some other medicines. Therefore, always tell your doctor which other medicines, herbal remedies or health food preparations you use.

Examples of theophyllines

  • Theo-Dur

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