It would be neat if asthma was like a sport.  Instead of writing dry, humorless posts, we could write exciting and entertaining posts about our theories and herald new inventions like the new vaccine that's supposed to cure allergies.

Another thing sports writers do that's fun is make fake rankings like this.  They have fun writing these, and we have fun reading them.  So I thought, for the fun of it, to rank 10 asthma medicines from worst to best (in my humble opinion of course).

So with sports on our minds, let's have a little fun with ranking common asthma medicines.  How do your meds stack up?  

10. Non-steroidal anti-inflammatory drugs (NSAIDS). Sorry to say it, but this one time classic team, which included Cromolyn and Tilade, has served its purpose and now finds its way in the trash heap of no-longer-used asthma medicines.  If you find yourself on these medicines still, chances are you have been, or will soon be, forced to try more modern medicines.  You may even find out the newer medicines allow you for even better asthma control. 

9.  Long-acting Beta Adrenergic (LABA): Powered by Serevent and Formoterol, these inhalers help asthmatics control bronchospasm long term and were one time top prospects in the asthma medicine farm system.  Yet things just never panned out for LABAs, as most studies show while these inhalers treat the symptoms, they don't control the underlying chronic inflammation present in most asthmatic lungs.  So asthma experts now contend if you need this medicine, you best be getting it in conjunction with an inhaled corticosteroid.  Or, better yet, you should check out #1 on this list.

8.  Oral steroids:  Yes, prednisone and solumedrol hit homeruns in those desperate situations when you need to gain control of inflammation in your lungs.  Yet, due to side effects, these meds are best avoided unless you really need them.  The best way to avoid this team is by obtaining and maintaining good asthma control, which is best achieved by being compliant with meds one to three on this list.

7. Oral Bronchodilators:  Fifteen years ago this was #2 on this list.  It was a powerhouse team led by Theophylline that lead many asthmatics to improved asthma control.  Yet now its usefulness has pretty much run out, and the old veteran was forced to retire.  It was a great bronchodilator in its day, but the risks and side effects are far greater than newer medicines used to control asthma.

6.  Immunomodulator:  Here we have the latest trend in asthma medicines -- the young prospect like Xolair -- the IgE inhibitors.  This is an expensive and one time injection that works to prevent asthma symptoms when you're exposed to your asthma triggers.  This is basically only used for those with severe asthma not controlled with other meds on this list.  Yet for some, I bet this medicine may be their #1 asthma medicines.  Until further studies show better results, we had better subdue our expectations, hence the low ranking.