Long-Term Relief Medications
These medications are taken on a regular basis to prevent asthma attacks and control chronic symptoms.
Inhaled Corticosteroids
Corticosteroids, also called glucocorticoids or steroids, are powerful anti-inflammatory drugs. Steroids are not bronchodilators (that is, they do not relax the airways) and have little effect on symptoms. Instead, they work over time to reduce inflammation and prevent permanent injury in the lungs. Many studies have now shown that the use of inhaled corticosteroids in patients with moderate-to-severe asthma significantly reduces the rate of rehospitalizations and deaths from asthma. Nevertheless, they are still significantly under-prescribed in the patients who need them most.
Inhalation of corticosteroids makes it possible to provide effective local anti-inflammatory activity in the lungs with minimal systemic effects. (Oral steroids have considerable side effects.) They are currently recommended as the primary therapy under the following circumstances:
- For any asthmatic condition more serious than occasional episodes of mild asthma. (Low-doses of inhaled steroids may even be safe and effective for some people with mild asthma, particularly those who find themselves using beta2-agonists daily.)
- When treatment with bronchodilators is not effective.
Examples of inhaled corticosteroids:
- The most recent generation of inhaled steroids include fluticasone (Flovent), budesonide (Pulmicort), triamcinolone (Azmacort and others), and flunisolide (AeroBid). In general, these newer steroids are more powerful than the older generation of inhaled drugs. These steroids are sometimes combined with a long-acting beta2-agonist in a single inhaler.
- The FDA approved a new inhaled corticosteroid, mometasone furoate (Asmanex) in 2005.
- The older corticosteroid inhalants are beclomethasone (Beclovent, Vanceril) and dexamethasone (Decadron Phosphate Respihaler and others). They are less powerful than the newer steroids when delivered with standard inhalers. New inhaler systems, such as QVAR, which uses extra fine formulations of beclomethasone to allow deep delivery into the lungs, may prove to be as effective as the newer, more potent steroids. Beclomethasone is believed to be safe during pregnancy.
- Inhalers that combine both long-acting beta2-agonists and corticosteroids are now available.
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