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Asthma Treatment

Bronchial Asthma is a chronic lung condition that is characterized by difficulty in breathing. People with asthma have extra sensitive or hyper-responsive airways. During an asthma attack, the airways become irritated and react by narrowing and constructing, causing increased resistance to airflow, and obstructing the flow of the air passages to and from the lungs.

There are two main types of medicines for the treatment of asthma:

Quick Relief Medicines: also called relievers, give rapid, short-term treatment and are taken when you have worsening asthma symptoms that can lead to asthma episodes or attacks. You will feel the effects of these medicines within minutes.
Long-Term Control Medicines: also called preventers, are taken every day, usually over long periods of time, to control chronic symptoms and to prevent asthma episodes or attacks. You will feel the full effects of these medicines after taking them for a few weeks. People with persistent asthma need long-term control medicines.

Drugs, such as those resembling two of our hormones, can help treat bronchial asthma. These two hormones are adrenaline (epinephrine in the USA) and hydrocortisone (a steroid).

There are also other drugs which help treat asthma. Whilst drugs can remove all your symptoms if you have mild asthma, people with more severe or long-standing asthma don't get nearly such good results, so alternate medications are required.

Adrenaline (epinephrine) is pumped into our bloodstream when we have a sudden fright or emergency. It is the quick-acting hormone from the middle of the adrenal glands near our kidneys. It makes your pulse race, makes your heart thump, and readies your body for emergency action. In asthma, the medicines which resemble adrenaline quickly relieve asthma for a short time, and are called relievers.

Hydrocortisone comes from the outer part of our adrenal glands, called the 'cortex'. It is also partly an “emergency hormone” but it works much more slowly, for much longer, and in a completely different way to adrenaline. Medicines which resemble hydrocortisone slowly allow the lining of air tubes in an asthma sufferer to become normal. As a result, your asthma becomes less severe and you are less likely to get asthma attacks. So these steroid medicines are called preventers. There are other asthma 'preventers', but the steroids are the most powerful.

Quick relief medicines are used only when needed. A type of quick relief medicine is a short-acting inhaled bronchodilator. Bronchodilators work by relaxing the muscles that have tightened around the airways. They help open up airways quickly and ease breathing. They are sometimes called "rescue" or "relief" medicines because they can stop an asthma attack very quickly. These medicines act quickly but their effects only last for a short period of time. You should take quick relief medicines when you first begin to feel asthma symptoms like coughing, wheezing, chest tightness, or shortness of breath. Anyone who has asthma should always have one of these inhalers in case of an attack. For severe attacks, your doctor may use steroids to treat the inflammation.

The most effective, long-term control medication for asthma is an inhaled corticosteroid because this medicine reduces the swelling of airways that makes asthma attacks more likely. Inhaled corticosteroids (or steroids for short) are the preferred treatment for controlling mild, moderate, and severe persistent asthma. They are safe when taken as directed by your doctor. Inhaled medicines go directly into your lungs where they are needed. There are many kinds of inhalers that require different techniques, and it is important to know how to use your inhaler correctly. In some cases, steroid tablets or liquid are used for short times to bring asthma under control. The tablet or liquid form may also be used to control severe asthma.

If you stop taking long-term control medicines, your asthma will likely worsen again.

Many people with asthma need both a short-acting bronchodilator to use when symptoms worsen and long-term daily asthma control medication to treat the ongoing inflammation. Over time, your doctor may need to make changes in your asthma medication. You may need to increase your dose, lower your dose, or try a combination of medications. Be sure to work with your doctor to find the best treatment for your asthma. The goal is to use the least amount of medicine necessary to control your asthma.