In order for you to be able to live an active life without limitations it is important that you receive the correct asthma medication and the correct asthma inhaler. There are two main types of medication that help when you have asthma; preventive medication decreasing the underlying inflammation of the airways and bronchodilators to use when needed, for example to treat acute problems or to avoid exercise induced asthma during exercise. Usually the medicine is inhaled via an inhaler.
The goal of asthma medication is for you to be free of asthma symptoms and for your lungs to be functioning normally. In order to achieve that it is important that you follow your doctor's treatment plan and that you take your preventive asthma medicines regularly, even if you feel well. It is important that you feel confident and competent in using your inhaler and that you know when you are using it correctly and even more importantly, that you know when you have been using it incorrectly (because that happens to everyone), so that you will be able to correct the error and get the dose you need. Poor compliance with your medication may lead to a worsening of the inflammation in the long run. If you are pregnant or breastfeeding it is especially important that you follow your doctor's recommendations and that you take your asthma medication regularly. It is a good idea for you to learn to recognise the early symptoms of asthma, so that you can increase your medication in good time and avoid an asthma attack. It could, for example, be that you become out of breath faster than usual when you exercise, that you start coughing at night or that you need to take more of your bronchodilating medication. By becoming an expert on your disease you will increase your chances of living a normal life.
Asthma cannot be completely cured, but the underlying disease can be treated effectively using anti-inflammatory asthma medicines. The most common preventative medication for asthma is inhaled steroids taken every day via an inhaler. Inhaled steroids are usually prescribed if you suffer from asthma problems at least two times a week and if the bronchodilating medicine is not sufficient for keeping the disease under control. Inhaled steroids prevent asthma attacks, decrease symptoms, improve lung function and make the airways less sensitive. They cannot, on the other hand, be used in order to immediately stop an on-going asthma attack.
Anti-inflammatory medications (inhaled steroids) are inhaled regularly and often have a good effect. If your asthma is severe or if you have both asthma and an allergy it may mean that you need complementary medication in the form of antileukotrienes tablets. If your asthma is deteriorating acutely, you may even have to take anti-inflammatory medication for one or two weeks.
The most common side effects of the inhaled medicines are hoarseness, fungal infection of the mouth, coated tongue and irritation of the throat and mouth. This is why it is important to rinse your mouth properly with water after having used an asthma inhaler. The antileukotrienes may cause side effects like stomach pains, nightmares and mood swings.
The dosage of the preventative medication varies depending on the severity of your asthma. It is common to take inhaled steroids in the morning and at night but if your asthma is mild and stable it may be sufficient to take them once a day. It may take a few weeks for the medicines to reach full effect, but it is important that you do not interrupt the treatment. The production of mucus and the swelling of the mucous membranes of the respiratory tract usually decrease gradually during the first few months.
Even if your asthma is well controlled, there may be occasions when you need to use bronchodilating medications that quickly counteract the muscle contraction of the airways (that can be caused by the asthma) and make it easier to breath. There are several different bronchodilating asthma medicines - those that act fast but have a shorter duration, and those with a longer duration. These bronchodilating medicines are called beta-2-adrenergic agonists. Depending on your symptoms, the asthma maybe treated with bronchodilators with short duration effect and which may be in addition to inhaled steroids. Long-acting bronchodilators may also be used as a complementary treatment. If you suffer from mild asthma problems, or for example only during exercise (exercise -induced asthma) an inhaler containing fast-acting bronchodilating medicine may be sufficient. It comes either as a dry powder or a spray.
For acute shortness of breath or cough a fast acting bronchodilator with short effect duration usually shows good results. The effect is quick, within 1-3 minutes, and lasts for 3-6 hours. This is why it is not used as a maintenance treatment but suits you better if you suffer from mild asthma that only sometimes needs treatment. There are also fast-acting bronchodilators with a long effect duration that lasts up to 12 hours. These should be used only as maintenance treatment in combination with preventive cortisone treatment for more severe problems, never as sole treatment.
Long-acting bronchodilators will treat symptoms over 12 hours. They may be given as an addition to preventative corticosteroid treatment in order to sufficiently ease symptoms during problematic periods. Some asthmatic people may then experience symptoms so severe that they will need both higher doses of inhaled cortisone and long-acting bronchodilators either continuously or periodically.
In cases where both inhaled steroids and long-acting bronchodilators are needed for long-term treatment due to severe asthma symptoms, a doctor may decide to prescribe inhalers containing both medicines.
UK/GEN/15/0055f Date of preparation: December 2015