Medicines are an important part of managing asthma. There are many different medicines available for treating asthma and many different devices to help to deliver these medicines to the body in the most effective way. It is an important part of dealing with your own asthma or that of your child that you know what these medicines are and what they do.

Asthma is an inflammation of the tubes that carry air down into the lungs. Normally these airways are wide open. However, with asthma they become narrowed and the air cannot flow properly in and out of the chest. The breathing tubes narrow in asthma because of inflammation or swelling of the airway walls. Many different forms of irritation can cause this.

What happens is that as the lining of the tubes swell, mucus pours in blocking the passageways, the muscle in the wall of the tubes tightens and it squeezes the tube. Asthma medications work to deal with these problems.

Preventers sooth the inflammation in the airways and keep asthma under control.

Preventers
Prevent swelling and mucus build-up, which narrows the breathing tubes.
Prevent ‘triggers’ from causing muscle-tightening around the breathing tubes.
Decrease the need for reliever medicines.
Only work if taken every day, even when you are well.
Do not produce instant improvement in your asthma but will give long-term control

If you notice any of the following signs, it is possible that your asthma medicine is not working and it is advisable to visit your doctor:
shortness of breath when you wake up in the morning
coughing, wheezing or a tight chest during sleep
more and more reliever treatment needed
effects of relievers lasting less than four hours
difficulty in maintaining usual level of activity or exercise.

There are three main groups of preventers:

Corticosteroids
Steroids reduce inflammation in the airways. They are usually given by inhaler but tablets may be required for severe asthma attacks. The safety of steroids in asthma has been established. However, they are powerful medications and there can be some side effects.

Corticosteroids available in Ireland include:
Asmabec clickhaler
Asmanex twisthaler
Becotide inhaler
Becotide 100 evohaler
Becotide 200 evohaler
Becotide 205 evohaler
Becotide 400 mcg
Becotide 50 evohaler
Deltacortril enteric
Delatcortril
Flixotide evohaler
Flixotide diskus
Flixotide nebules
Pulmicort inhaler
Pulmicort turbohaler
Pulmicort LS
Pulmicort respules
Seretide evohaler
Seretide diskus
Symbicort turbohaler

Effects of preventers

Use of preventers (usually in brown inhalers) result in less coughing and mucus and fewer episodes of wheezing. These are taken daily to prevent breathing problems occurring. They work slowly, so you may not notice much difference initially but within several weeks a full effect will be seen. Once preventers are used regularly, they are very effective.

Preventers need to be taken regularly, usually morning and night. In well-controlled asthma, using a once-daily dose is becoming more common.

You doctor will draw up a management plan with you. This will be reviewed when necessary. The written plan explains how to decrease to low doses when you are well and when to stop and start if your symptoms are seasonal. It also explains what to do if your symptoms get worse

There are some possible side effects of these medications. A husky voice can occur. Sore throat or thrush (a fungal growth) can occur in the mouth. These are less likely when a spacer device is used to deliver the medication, or when a dry powder inhaler is used. A good tip is to gargle and spit out after using the inhaler.

Asthma medicines are safe during pregnancy and are not addictive. You need to check with your doctor or nurse that you are using your inhaler correctly so that adequate levels of medication are getting into your lungs.

It is important that you explain to your doctor or nurse about any side effects or problems that you have with your medication. Always let your health professional know if you are taking any over-the-counter remedies or any other preparation. Similarly, if you are buying any remedy from the pharmacy, let them know what medicines you are taking.

It is advisable that you do not stop taking prescribed asthma medication unless you talk to your doctor or nurse first.

For more information, contact the Asthma Society of Ireland on freephone, 1850 44 54 64.

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