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Dec 6, 2022

Allergies

Asthma

Asthma

Inhaler for Asthma

According to the CDC, 1 in 13 Americans struggles with Asthma. Although there is no cure for asthma, you can manage it with treatment and a therapy plan.

What is Asthma?

Asthma is a long-term disease that affects the airways (bronchi) of your lungs. This medical condition causes airway inflammation and bronchoconstriction (the smooth muscles in your bronchi become tight, narrowing your airways). The muscles around your airways tighten during an asthma attack, and the lining of your airways swells and narrows.

The inflammation and bronchoconstriction cause airflow obstruction, which leads to expiratory airflow limitation, making it difficult for you to exhale. This results in frequent episodes of wheezing, coughing, chest tightness, and breathlessness.

The inflammation and bronchoconstriction in asthma are reversible with medications.

What are the symptoms of asthma?

  • Chest tightness and/or pain
  • Shortness of breath (SOB)
  • Wheezing when exhaling; is generally a common sign of asthma in children
  • Trouble sleeping due to SOB, coughing, and/or wheezing
  • Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Some individuals may experience flare-ups of their asthma symptoms in particular situations.

  • Occupational asthma—asthma brought on by irritants in the workplace, such as chemical fumes, gases, and/or dust
  • Exercise-induced asthma—consists of signs and symptoms of asthma that may worsen in cold and dry air
  • Allergy-induced asthma—asthma that’s triggered by airborne allergens including pollen, mold spores, cockroach waste, and/or particles of skin and dried saliva shed by animals (pet dander)

What triggers asthma?

The triggers for an asthma attack may vary from person to person; some individuals may experience bronchoconstriction from their pet, and others do not.

Individuals with asthma need to learn their personal triggers and avoid them when possible. If the trigger cannot be avoided, acute treatment may be necessary.

Asthma triggers

  • Pollution
  • Cigarettes/tobacco smoke
  • Cold air/changes in the weather (i.e. high humidity)
  • Pets
  • Dust, pollen, and/or cockroaches
  • Perfume and cosmetics
  • Physical exercise
  • Sinus infections
  • Inhaling certain chemicals
  • Acid reflux
  • Drugs (I.e. Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs - such as ibuprofen or naproxen), and certain beta-blockers)
  • Certain foods

How is asthma treated?

Medications used for asthma come in oral, inhaled, and injectable formulations. Inhaled forms deliver the medication directly into your lungs, have less toxicity, and are the preferred formulations for asthma treatment.

Medications used to treat asthma long-term are referred to as relievers (rescue inhalers) or controllers (maintenance drugs).

  • Rescue inhalers (“quick-relief” inhalers): These types of medications rapidly open your airways within minutes of inhalation to make it easier for you to breathe. Rescue inhalers can also be used as an intermittent treatment for acute asthma symptoms, often used as a preventative for exercise-induced asthma.

    Frequently using rescue inhalers (greater than 2 days per week) indicates worsening asthma control and a need to reassess, and possible step-up treatment.

  • Controllers (maintenance drugs): are preventative long-term medications that are taken on an ongoing, daily basis to reduce inflammation and maintain asthma control.

All metered dose inhalers (MDI) are aerosol-based inhalers and should be shaken well before use.

All dry powder inhalers (DPI) deliver medications to your lugs in the form of dry powder.

Medications to treat asthma

Beta-2 Agonists

A drug class of medications that attach to the beta-2 receptors, causing relaxation of bronchial smooth muscle, resulting in the widening of your bronchi, alleviating your asthma symptoms.

Short-acting beta-2 agonists (SABAs)

Use as needed (rescue therapy) for acute asthma symptoms

  • Albuterol (ProAir HFA, ProAir RespiClick, Proventil HFA, Ventolin HFA, ProAir Digihaler): MDI/DPI: 1–2 inhalations every 4-6 hours as needed
  • Levalbuterol (Xopenex, Xopenex concentration, Xopenex HFA): MDI: 1-2 inhalations every 4–6 hours as needed
  • Epinephrine (Primatene mist): MDI: 1–2 inhalations every 4 hours as needed
    Available as an over-the-counter medication
    Epinephrine is FDA approved for mild symptoms in intermittent asthma only

Common side effects

  • Nervousness
  • Tremor
  • Increased heart rate
  • Palpitations
  • Hyperglycemia (high blood sugar)
  • High blood potassium levels
Long-acting beta-2 agonists (LABAs)

Medications used as part of maintenance therapy and in combination with inhaled corticosteroids (ICS).

  • Salmeterol (Serevent Diskus): DPI: 1 inhalation twice a day
    This medication is a maintenance inhaler that should never be used alone and should always be used in combination with an ICS because it may cause asthma-related deaths.
    Common side effects are the same as SABAs.

Inhaled corticosteroids (ICS)

This drug class of medications works by inhibiting the inflammatory response. They block the reaction to the allergen, reduce array hyper- responsiveness, and are potent and effective anti-inflammatory medications.

ICS medications decrease symptoms, increase your lung function, improve your overall quality of life, and decrease the risk of asthma exacerbations.

  • Beclomethasone (QVAR RediHaler): 1MDI: 1–4 inhalations twice a day
  • Budesonide (Pulmicort Flexhaler, Pulmicort Respules): DPI: 1–4 inhalations twice a day
  • Ciclesonide (Alvesco): MDI: 1–2 inhalations twice a day
  • Fluticasone (Flovent HFA, Flovent Diskus, Flovent Ellipta)
    Flovent HFA: MDI: 2 inhalations twice a day
    Flovent Diskus: DPI: 1&ndahs;2 inhalations twice a day
    Flovent Ellipta: DPI: 1–2 inhalations daily
  • Fluticasone + Salmeterol (Advair Diskus, Advair HFA, AirDuo RespiClick, Wixela Inhub)
  • Mometasone (Asmanex HFA, Asmanex Twisthaler)
    Asmanex HFA: MDI: 1–2 inhalations twice a day
    Asmanex Twisthaler: DPI: 1–2 inhalations daily

Common side effects

  • Difficulty speaking
  • Cough
  • Headache
  • Hyperglycemia
  • Hoarseness (raspy or strained voice)
  • Oral candidiasis, also known as thrush
    Oral thrush is a fungus infection in the mouth.
    To prevent oral thrush, rinse your mouth and throat with warm water and spit it out after each use, or use a spacer device if using an MDI.

Leukotriene receptor antagonists (LTRAs)

Drug class of medications that works by inhibiting leukotriene mediators of airway inflammation. This action results in reduced airway edema (swelling), inflammation, and constriction.

  • Montelukast (Singulair): 10 mg daily in the evening
    For children ages between 6–14 years old: 5 mg daily in the evening
    For children ages between 1–5 years old: 4 mg daily in the evening
    Montelukast granules can be administered directly in your mouth, dissolved in a small amount of breast milk or formula, or mixed with a spoonful of applesauce, carrots, rice, or ice cream; this medication should not be mixed with anything else and used within 15 minutes of opening the packet
  • Zafirlukast (Accolate): 20 mg twice a day
    This medication should be taken 1 hour before or 2 hours after meals (on an empty stomach)
  • Zileuton (Zyflo, Zyflo CR)
    Zyflo: 600 mg four times a day
    Zyflo CR: 1,200 mg twice a day within 1 hour after morning and evening meals

Common side effects

  • Headache
  • Dizziness
  • Abdominal pain
  • Upper respiratory tract infection

Theophylline

This mediation causes bronchodilation which relaxes the smooth muscles located in your bronchial airways and pulmonary blood vessels. Maintenance dose: 300-600 mg daily

Common side effects

  • Nausea
  • Vomiting
  • Headache
  • Increased heart rate
  • Insomnia
  • Tremor
  • Nervousness

Speak With Your Doctor

You can live a successful and active life with asthma if you adhere to treatment and follow an appropriate asthma plan.

Talk to your healthcare provider today and send your prescription to Marley Drug. Save up to 95% compared to your local pharmacy by using Marley Drug.

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