Short-acting rescue medicines can be used to treat acute asthma symptoms or for long-term control.
Asthma Inhaler for a Child
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Children are more likely to benefit from inhaled medicines if a spacer is used with
metered-dose asthma inhalers
University of Arizona
offers a table that compares the different brands of spacers. A study, though, found that there was no difference in how medicine was delivered with homemade versus store-bought spacers. Talk to your doctor to find out what is right for you or your child.
Common names of beta-2-agonists (inhalers) include: AlbuterolLevalbuterolPirbuterol
These drugs are bronchodilators, meaning they open the airways by relaxing the muscles around bronchial tubes. This can provide quick relief of acute symptoms. They can also be used as preventive medicines prior to exercise.
You must be careful not to overuse these drugs and contact your doctor immediately if your symptoms are not controlled.
Common side effects include: Fast heartbeatHeadacheNervousnessTremor
is a bronchodilator. This is a type of medicine that opens up narrowed breathing passages and may decrease mucus secretion.
Tiotropium, a closely related medicine, has also been studied for use in patients with asthma. These medicines are taken by inhalation to help control the symptoms of lung diseases, particularly
. Ipratropium and tiotropium help decrease coughing, wheezing, shortness of breath, and troubled breathing by increasing the flow of air into the lungs.
When ipratropium inhalation is used to treat acute, severe attacks of asthma, bronchitis, or emphysema, it is usually used in combination with other bronchodilators. While these drugs are not commonly used to treat asthma except in the emergency room setting, there is some evidence that tiotropium can reduce the need for oral or inhaled corticosteroids in people with very severe and persistent asthma.
Common side effects include: CoughDryness of mouthUnpleasant taste
Common names include: MethylprednisolonePrednisonePrednisolone
These drugs are frequently used for a short duration to prevent the progression of moderate or severe symptoms, reverse inflammation, speed recovery, and reduce the risk of relapse. They are not truly rescue medicines, but help prolong the effect of beta-2 agonist rescue.
Possible side effects include: IndigestionLowered resistance to infectionsAbnormalities in glucose metabolismIncreased appetiteMood alterationFluid retention
Long-term “control” medicines are used to achieve and maintain long-term management of symptoms and reduce inflammation.
Common names include: BeclomethasoneBudesonideFlunisolideFluticasoneMometasone
These drugs suppress, control, and reverse inflammation. They can reduce the need for oral corticosteroids and rescue medication, and play a role in the long-term management of asthma.
Possible side effects include: Oral thrushCough
Common names include: MethylprednisolonePrednisolonePrednisone
These drugs help reduce inflammation and prevent escalation of symptoms. Oral corticosteroids can produce more side effects than inhaled corticosteroids. Long-term use of oral corticosteroids is not generally recommended. However, your doctor may prescribe oral corticosteroids for long durations only when other treatments have failed to restore normal lung function and the risks of uncontrolled asthma are greater than the side effects of the medicine.
Possible side effects include: Indigestion, nausea, and possibly bleeding in the stomachLowered resistance to infectionsGrowth suppression (in children)ObesityDiabetes mellitusHypertension
(high blood pressure)
(thinning of the bones)
CataractsAdrenal suppressionMuscle weakness
Common names include: Cromolyn sodiumNedocromil
These drugs are occasionally used for long-term prevention of symptoms. They may modify inflammation and can be used as preventive treatment prior to exercise.
Possible side effects include: Unpleasant tasteCough
Common names include: SalmeterolFormoterol
These drugs provide long-term prevention of symptoms, especially nighttime symptoms and are often added to anti-inflammatory therapy such as inhaled corticosteroids. They may also be used as preventive treatment prior to exercise or contact with a known allergen. However, they should not be used during an acute attack.
Possible side effects include: Rapid heart beatTremorDifficulty sleeping, nervousness
Long-acting inhalers, like salmeterol, may increase the risk of asthma-related death, intubation (putting a tube in the windpipe to breathe), and hospitalization.
This is most likely to occur when they are mistakenly used as rescue inhalers. These medicines are almost always prescribed together with an inhaled corticosteroid.
If you have any concerns, talk to your doctor.
Common names include: Theophylline
This type of drug provides long-term control and prevention of symptoms, especially nighttime symptoms. It works by opening the airways and relaxing the muscles around the bronchial tubes. It also increases the ability to clear mucus out of the airway.
Possible side effects include: HeadacheFast heartbeatDifficulty with urinationNervousnessTrouble sleepingUpset stomach
Leukotriene inhibitors are medicines that decrease inflammation by preventing the action of leukotrienes. These types of medicines are not used to relieve acute symptoms, but can be used to prevent your symptoms from occurring.
Possible side effects include:
Flu-like symptomsNervousness, excitabilityHeadacheStomach painCoughZileuton
Leukotriene blockers are medicines that decrease inflammation by production the action of leukotrienes. Used for long-term control and prevention in mild persistent asthma.
Possible side effects include
elevation of liver enzymesinteractions with other medicines
Common names include: Omalizumab
This is an injected medicine that binds to IgE, a type of antibody that contributes to allergic symptoms. These drugs provide long-term control and prevention of symptoms in mild, persistent asthma.
Possible side effects may include:
Pain and bruising at the injection siteAnaphylaxis
has been reported
Common names include: Fluticasone and salmeterolBudesonide and formoterol
These drugs provide long-term control and prevention of symptoms by combining the effects of a long-acting beta-2-agonist and inhaled steroid into one formulation (which makes dosing more convenient).
The side effects are similar to those described above for the individual medicines.