Quick-relief medications

These asthma medications open the lungs by relaxing airway muscles. They're often called rescue medications because they can ease worsening symptoms or stop an asthma attack in progress. They begin working within minutes and are effective for four to six hours. For some people, using a quick-relief inhaler before exercise helps prevent shortness of breath and other asthma symptoms. Possible side effects include jitteriness and palpitations.

Quick-relief medications include:

  • Albuterol (ProAir HFA, Ventolin HFA, others)
  • Levalbuterol (Xopenex HFA)
  • Pirbuterol (Maxair)

If your symptoms are minor and infrequent, or you have exercise-induced asthma, you may be able to manage your symptoms with one of these medications alone. However, most people with persistent asthma need to rely primarily on an inhaled corticosteroid or other long-term control medication. Short-acting asthma medications are often used to treat asthma attacks and exercise-induced asthma, but they shouldn't be used on a regular, daily basis. If you need to use your inhaler more often than your doctor recommends, your asthma is not under control — and you may be increasing your risk of a serious asthma attack.

Ipratropium (Atrovent) is a short-acting bronchodilator that's usually prescribed for emphysema or chronic bronchitis, but is sometimes used to treat asthma attacks. It may be used along with — or as an alternative to — short-acting beta agonists.

Oral corticosteroids for serious asthma attacks
These medications may be taken to treat severe asthma attacks. They can cause bothersome short-term side effects and more-serious side effects if they're taken for a long period of time. Examples include:

  • Prednisone
  • Methylprednisolone

Long-term use of these medications can cause side effects including cataracts, thinning bones (osteoporosis), muscle weakness, decreased resistance to infection, high blood pressure and reduced growth in children.

Medications for asthma triggered by allergies

Medications that focus on treating allergy triggers include:

  • Allergy shots. Allergy shots (immunotherapy) may be an option if you have allergic asthma that can't be controlled by avoiding triggers. You'll begin with skin tests to determine which allergens trigger your asthma symptoms. Then you'll get a series of injections containing small doses of those allergens.

    You generally receive injections once a week for a few months, and then once a month for a period of three to five years. In some cases, desensitization can be done more quickly. Over time, you should lose your sensitivity to the allergens.

  • Omalizumab. Omalizumab (Xolair) is sometimes used to treat asthma triggered by airborne allergens. If you have allergies, your immune system produces allergy-causing antibodies to attack substances that generally cause no harm, such as pollen, dust mites and pet dander. Omalizumab blocks the action of these antibodies, reducing your immune system reaction that causes allergy and asthma symptoms.

    Omalizumab is given by injection every two to four weeks. It isn't generally recommended for children under 12. In rare cases, this medication has triggered a life-threatening allergic reaction (anaphylaxis). Anyone who takes omalizumab should be monitored closely by health professionals after getting an omalizumab injection in case of a severe reaction.

  • Allergy medications. These include oral and nasal spray antihistamines and decongestants as well as corticosteroid and cromolyn nasal sprays. Allergy medications are available over-the-counter and in prescription form.

    Corticosteroid nasal spray helps reduce inflammation without causing the rebound effect sometimes caused by nonprescription sprays. Because it has few, if any, side effects, cromolyn is safe to use over long periods of time.

Making the most of your asthma medications

Carefully tracking symptoms and side effects — and adjusting your treatment accordingly — is the key to keeping your asthma symptoms under control. With your doctor or other health care providers, write a detailed plan for taking long-term control medications and for managing an asthma attack. Then, carefully follow your plan.

Know when to adjust your medications, when to see your doctor and how to recognize an asthma emergency. If your doctor has prescribed a peak flow meter to measure how well your lungs are working, use it according to your plan. Even if you feel well, keep taking your medications as prescribed and tracking your symptoms until you talk to your doctor.

Sept. 20, 2012 See more In-depth