Treatment for AsthmaBy Martin BeckfordHealth Correspondent. Academics non steroidal medication for asthma a pill that is rarely prescribed in Britain is just as effective at controlling the long-term breathing condition as traditional inhalers. But because it is easier to take and users feel athma self-conscious about doing so, asthma sufferers were found to be far more likely to stick with the medication. Asthma, caused by narrowing of the airways in the lungs and leading to breathlessness and wheezing, often develops in childhood and affects at least 5million Britons. They use non steroidal medication for asthma to reduce inflammation in the airways. Tablets called Leukotriene Receptor Antagonists LTRAs how well do testosterone shots work long been on the market as an alternative to inhalers but they are currently only recommended as a third or fourth option on the NHS so are rarely prescribed.
Newer and alternative non-steroidal treatments for asthmatic inflammation. - PubMed - NCBI
This section will provide information on preventer medications used in the treatment of asthma. All medications have a commercial name, and a chemical name. Generic products often use the chemical name. In this site, drugs' chemical names are given in brackets.
Inhaled steroids are designed to go directly to where they're needed the lungs , with extremely little of the drug reaching the rest of the body.
This lets inhaled steroids act as extremely effective preventer -type medications, while markedly reducing the risk of steroid-type side effects. Inhaled steroids are used to prevent asthma attacks, and improve overall asthma control. Because inhaled steroids usually take weeks to start working, inhaled steroids generally work best when taken on a regular basis, long-term, using them for a season at a time or longer.
Because inhaled steroids begin working relatively slowly, if your child is started on an inhaled steroid and isn't better after a couple of weeks, you shouldn't get discouraged.
Obviously, if during this time, your child gets worse, you should notify your doctor. Some doctors recommend that when asthma symptoms or peak flows show signs of steady worsening, the inhaled steroid dose should be doubled or tripled. Studies have not shown that doubling the dose during attacks is generally effective. There are studies in adults showing that quadrupling the dose during attacks is effective.
However, during a severe asthma attack, oral steroids are recommended to prevent worsening of the severe asthma attack. Several inhalers containing a combination of inhaled steroid and long-acting Beta-2 Agonist are available in Canada. A long-acting Beta-2 Agonist can be useful for reducing asthma symptoms in people who still have symptoms despite appropriate use of an inhaled steroid.
One major advantage of a combination inhaled steroid and long-acting Beta-2 Agonist inhaler is convenience, for people requiring both an inhaled steroid and a long-acting Beta-2 agonist. In addition, for adolescents, the combination product will prevent them from using only the Beta-2 agonist which provides fairly rapid symptom relief but will instead ensure that they also receive the inhaled steroid, to provide an anti-inflammatory, preventer effect.
Advair TM is licensed in Canada for individuals 4 years of age and older. Standard doses of inhaled steroids may cause minor changes in the balance of natural steroid hormones which are produced by the body. This does not seem to be of any clinical significance. Very high doses of inhaled steroids or inhaled steroid-long-acting Beta-2 agonist combination inhalers may cause the adrenal glands to work less well.
The adrenal glands naturally produce steroids, and produce higher levels during periods of stress, such as during infections or surgery. When the adrenal glands work less well, this is known as adrenal suppression. Many, but not all, children with adrenal suppression due to steroids also have reduced growth.
If you are worried that your child could have adrenal suppression, you can ask your doctor for a blood test. The blood test, called a serum cortisol, needs to be done first thing in the morning before 8: Children on high doses of inhaled steroids or prolonged over 2-week treatment with steroids by mouth should have a morning cortisol test once or twice a year. Children with severe asthma may frequently need Oral Steroids.
By reducing the severity of asthma, inhaled steroids generally reduce the need for oral steroids. Studies have shown that being on an inhaled steroid all year long has less effect on natural steroid hormone balance than 4 courses of oral or intravenous steroids in a year. Note that if your child is on inhaled steroids and your doctor recommends a course of oral steroid to control an asthma attack, your child should take the oral steroid because it can prevent a severe asthma attack.
When used for long periods many months or more , oral steroids can cause reduced growth, thinning of the bones, eye problems, high blood pressure, difficulties dealing with stresses like surgery known as adrenal suppression, reduced ability to handle infections especially chickenpox , and weight gain.
Because of the potential for these kinds of side effects, patients on long-term treatment with oral steroids are monitored closely by a doctor. Non-steroid preventer medications interfere with either certain inflammatory cells in the lungs, or with the chemicals these cells release. This reduces lung inflammation, improving asthma control and preventing asthma attacks.
There is one non-steroid preventer medication available in Canada: Leukotrienes are chemicals released by inflammatory cells in the lungs, that play a key role in inflammation. Anti-leukotriene medications work by blocking the action of these leukotrienes. In Canada, there is one anti-leukotriene medication available: It is normally given on a long-term, regular basis to prevent asthma attacks and improve asthma control, although there is some evidence it may be helpful if used during colds.
This may be adequate for patients with mild asthma, but patients with moderate or severe asthma such as patients with attacks severe enough to need visits to an Emergency Room or admission s to hospital will generally have better asthma control if they take an inhaled steroid. An anti-leukotriene medication may be helpful when combined with an inhaled steroid. Combined treatment, with an anti-leukotriene medication and an inhaled steroid may result in fewer symptoms than using the inhaled steroid alone, and it may allow the doctor to reduce the amount of inhaled steroid needed by the child.
In a child who needs an inhaled steroid to prevent severe asthma attacks, decreasing the inhaled steroid dose too much or stopping the inhaled steroid could put the child at risk for a severe attack. If your child is taking an inhaled steroid and your doctor adds an anti-leukotriene medication, the inhaled steroid should not be stopped abruptly, and the dose should not be reduced without your doctor's advice. These medications are given in pill-form or a sprinkle that can be sprinkled on apple sauce, rather than by inhaler.
This is convenient for many people. These medications take about days to start working, and reach maximum effect in 3 weeks. Risk Factors and Outcome Asthma Triggers: What are Common Patterns of Asthma in Children? Disclaimer Health Records MyChart. Childhood Asthma Asthma Medications Preventers This section will provide information on preventer medications used in the treatment of asthma. Tell Me More About Preventer Medications There are two types of preventer or anti-inflammatory medications for asthma.
They are the steroid-type preventer medications , and the non-steroid-type preventer medications. Steroid-Type Preventer Medications Steroids act directly on the inflammatory cells that cause asthmatic reactions in the lungs. They are the most consistently-effective preventer medications used to treat asthma.
The steroid medications used in asthma treatment are different from the anabolic steroids that have been mis-used by athletes, for example, in the Olympics. Steroid medications used for long-term prevention of asthma attacks are almost always given by inhaler. During asthma attacks, steroids given by pill or liquid are used by many doctors to prevent worsening of a severe attack. A few, very severe, asthmatics, need to take oral pill or syrup steroid medications on a regular basis.
Inhaled Steroids Inhaled steroids are designed to go directly to where they're needed the lungs , with extremely little of the drug reaching the rest of the body.
A few people have dry mouth or throat irritation. This is usually minor. Inhaled steroids can cause Thrush in the mouth little white patches, caused by a yeast infection.
If this happens, it is usually treated with a special anti-yeast antibiotic. Thrush can be prevented by: Very, very, rarely, inhaled steroids can cause a hoarse voice. The effect of inhaled steroids on growth are difficult to measure, because severe, uncontrolled asthma affects growth. Children on inhaled steroids should have their growth carefully monitored. One recent study suggests that inhaled steroids may cause a short-term decrease in growth.
As children with asthma often have catch-up growth in puberty, it is not known whether this leads a decrease in the final adult height. Many children on inhaled steroids grow just fine. A few actually grow better on inhaled steroids — because their asthma comes under better control. Some research has suggested that the risk of glaucoma fluid build-up, causing increased pressure in the eye may be increased in elderly people using high doses of inhaled steroids for long periods of time.
Glaucoma is much more common in the elderly, and extremely rare in children. There are no studies available to suggest that inhaled steroids increase the risk of glaucoma in children, and this problem has not been seen in children on inhaled steroids in the Ottawa region. Canadian studies have shown that cataracts, which can occur from long term use of Oral steroids, do not occur with long term use of inhaled steroids. Canadian guidelines have been issued recommending that people with asthma who need inhaled steroids should continue using them.
Obviously, if you are concerned that your child has an eye problem or difficulties seeing whether or not they are receiving inhaled steroids , you should have your child seen by an eye specialist, and have the Intra-Ocular Pressure recorded. Oral Steroids Steroids can be given by mouth or, in a hospital setting, injected either through an intravenous, or into the muscle.
Steroids, when given in such ways, powerfully reduce inflammation , and are effective in helping control severe asthma attacks. Oral steroids are usually given for day periods; when used for a week or more, the dose is usually slowly tapered down over a varying period of time. Oral steroids rarely have serious side effects when given for day periods. In a few, very severe asthmatics, oral steroids are used for months at a time or even longer.
This should be done under the careful supervision of a doctor. When oral steroids are used for months at a time or longer , there is a potential for a number of serious side effects. Serious side effects are uncommon. Non-Steroid Preventer Medications Non-steroid preventer medications interfere with either certain inflammatory cells in the lungs, or with the chemicals these cells release. NSAIDs can actually worsen asthma in some asthmatics.
Anti-Leukotriene Medications Leukotrienes are chemicals released by inflammatory cells in the lungs, that play a key role in inflammation. It is given as a single dose, at bedtime. Anti-leukotriene medications may be used on their own, or together with an inhaled steroid. These medications occasionally cause headaches and stomach aches. Occasionally, children can develop behavior problems, such as mood changes, irritability, or nightmares, and adolescents can develop depression.
The symptom s go away when the medication is stopped. Very rarely, patients on these medications have developed liver problems. There had previously been a concern about patients very rarely developing a rare disease called Churg Strauss Syndrome. Churg Strauss Syndrome involves inflammation of blood vessels, abnormal shadows on the chest X-ray, and heart problems.