Overview of Asthma Medications

Asthma medication can be divided into two categories:

  1. Quick-relief or rescue asthma medication
  2. Controller asthma medication

Quick-relief asthma medication treats acute asthma symptoms, such as wheezing, chest tightness, shortness of breath, and coughing. Controller asthma medication, on the other hand, attempts to prevent these same symptoms. For the most part, all asthma medication is inhaled, although some do come in a liquid form and one is given as an infusion. Let’s take a look at the options.

Asthma medication. Set of inhalers and medication
barmalini / istockphoto / Getty Images

Inhaled Steroids

Inhaled steroids are the most important asthma medication because they are the most potent and effective option available for long-term control. Their anti-inflammatory properties are responsible for the significant improvement that is often associated with the use of this asthma medication. Inhaled steroids prescribed may include:

  • Alvesco (ciclesonide)
  • Asmanex (mometasone furoate)
  • Flovent (fluticasone propionate)
  • Pulmicort (budesonide)
  • Qvar (beclomethasone dipropionate)

Short-Acting Beta Agonists (SABA)

SABAs are a type of drug class commonly used in quick-relief asthma medications. This type of asthma medication is the drug of choice for the acute relief of asthma symptoms and is also used to prevent exercise-induced asthma. Because this asthma medication can prevent your asthma symptoms from getting worse, it is important to always keep it with you. Some of the SABAs include:

  • Proventil (albuterol)
  • Ventolin (albuterol)
  • Xopenex (levalbuterol)

Long Acting Beta Agonists (LABA)

This type of asthma medication is preferred when your inhaled steroids are not adequately controlling your symptoms, otherwise known as adjunctive therapy. LABAs are not used as a single asthma medication for the treatment and prevention of symptoms and are not used to treat acute asthma symptoms or asthma exacerbations. LABAs include:

  • Foradil (formoterol fumarate)
  • Serevent (salmeterol xinafoate)

Leukotriene Modifiers

This type of asthma medication is considered an alternative treatment for people with mild persistent asthma and can be used as adjunctive therapy with inhaled steroids. Exercise-induced asthma can also be controlled with them. Some leukotriene modifiers that are currently available include:

  • Accolate (zafirlukast)
  • Singulair (montelukast)
  • Zyflo (zileuton)

Oral Steroids

Oral steroids are used for the treatment of moderate and severe asthma exacerbations to help improve symptoms and to prevent the late phase response of the allergic cascade. Oral steroids are only used as a controller medication after multiple other medications fail.

Anticholinergics

Anticholinergics act as a bronchodilator and are often used in combination with SABAs in the acute treatment of asthma symptoms in the emergency room or hospital. Spiriva (tiotropium bromide), a long-acting anticholinergic medication, is a controller medication for asthma that is used along with an inhaled corticosteroid for the treatment of moderate persistent asthma.

Cromolyn Sodium

Cromolyn is an alternative treatment for people with mild, persistent asthma. It helps prevent inflammation in the lungs. This drug is never used for the treatment of acute asthma symptoms.

Combination Asthma Medication

A number of pharmaceutical companies have combined products, with more than one type of asthma medication in a single inhaler. Most commonly, this includes an inhaled steroid plus a LABA. The LABA widens your lung airways and the inhaled steroid decreases and prevents airway inflammation.

People find this type of asthma medication more convenient and often feel like they have better control. Examples include:

  • Advair (fluticasone propionate and salmeterol)
  • Symbicort/Breyna (budesonide and formoterol fumarate dihydrate)

Immunomodulators

Immunomodulators are a group of drugs that either provide long-term control of asthma or are considered steroid sparing. These medications alter your immune system’s response to asthma triggers. In general, these treatments decrease your IgE response to asthma triggers. Immunomodulators include:

Methylxanthines

Two members of this class of substances (theophylline and aminophylline) work as mild bronchodilators and are considered alternative adjunctive treatments to be used with other asthma treatments.

By Pat Bass, MD
Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians.