Asthma Medications: Preventive and Relief Treatments

The goal of asthma treatment is not just to manage attacks, but to prevent them from happening in the first place by controlling inflammation in the airways. Therefore, asthma medications are divided into two main groups: preventative medications that reduce inflammation and bronchodilator medications that quickly open up the narrowed airways.

Protective (control) drugs

The base of this group is inhaled corticosteroids (ICS) . ICS reduce inflammation and swelling in the airways, making them less sensitive to triggers. Their effects are not felt immediately; they become noticeable within a few days to a few weeks with regular use.

Inhaled steroids are effective at very low doses because they reach the lungs directly. They should not be confused with tablet steroids and can be used safely for an extended period at the appropriate dose. Rinsing the mouth after use reduces the risk of oral thrush and hoarseness.

Long-acting bronchodilators (LABAs) are added to the ICS when needed. These two are usually combined in a single inhaler.

Relief (rescue) drugs

Bronchodilator medications work within minutes, relaxing the bronchi. For many years, only short-acting bronchodilators (SABA, for example, salbutamol) were used for this purpose.

The current international asthma guidelines, GINA, recommend that asthma in adolescents and adults should not be treated with SABA alone . This is because SABA provides temporary relief from symptoms but does not treat the underlying inflammation. Frequent SABA use is associated with an increased risk of severe attacks.

Current approach: IKS-formoterol

GINA's preferred approach involves using a low-dose ICS-formoterol inhaler as a symptom reliever. Formoterol relieves symptoms quickly, while the simultaneously administered steroid treats inflammation. Therefore, each use of the symptom reliever also includes a protective medication.

• For mild asthma: This inhaler should only be used when symptoms are present.

• In moderate to severe asthma: The same inhaler is used daily both as a preventative measure and as a reliever when needed. This method is called single-inhaler maintenance and reliever therapy (MART or SMART).

Studies have shown that in mild asthma, this approach significantly reduces severe attacks compared to using SABA alone. However, your doctor will decide which method is right for you. The treatment plan is different for children, especially those under five years old.

Other medications

• Leukotriene receptor antagonists (e.g., montelukast): Available in tablet form. They may cause sleep and mood changes in some individuals; any such changes should be reported to a doctor.

• Long-acting anticholinergics (LAMAs): These are added to treatment in some patients.

• Biological drugs: In severe asthma, these are injection treatments that target specific types of inflammation. They are planned by a specialist physician.

• Tablet steroids: Used for short periods during severe attacks. Frequent need for them indicates that asthma is not under control.

Things to keep in mind

• Don't stop taking your preventative medication on your own when you feel better. Feeling better often means the medication is working.

• Always carry your reliever inhaler with you.

• Talk to your doctor if you need sedatives more often than usual.

This text is for informational purposes only. Always consult your doctor before starting, stopping, or changing the dosage of any medication.