Asthma: Over The Counter Treatment (cont.)
George Schiffman, MD, FCCP
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Asthma introduction
- What is asthma?
- What medications are used to treat asthma?
- How do over-the-counter (OTC) asthma medications work?
- What factors should be considered in choosing and using OTC epinephrine or ephedrine?
- What side effects and drug interactions are there with OTC asthma medicines?
- What are additional measures in the management of asthma?
- Find a local Asthma & Allergy Specialist in your town
What is asthma?
The cause of asthma is unknown. More is known about the abnormal conditions that occur in asthma. These conditions include:
- hyper-responsiveness (contraction) of the muscles of the breathing airways in response to many stimuli such as exercise or allergies (for example, drugs, food additives, dust mites, animal fur, and mold);
- inflammation of the airways;
- shedding of the tissue lining the airways;
- increased secretion of mucus in the airways; and
- swelling of the airways with fluid.
All of these conditions narrow the airways and make breathing difficult. Asthma symptoms include wheezing (the hallmark of asthma), coughing, difficulty breathing, and tightness of the chest. Asthma is diagnosed by the presence of wheezing, but it can be confirmed by breathing tests (spirometry) that evaluate the movement of air into and out of the lungs. Some have a type of asthma referred to as cough variant asthma. In this situation, patients have a cough that is chronic or recurrent with the presence of normal lung function.
What medications are used to treat asthma?
Prior to modern medicine, a variety of plants, herbs were smoked in effort to treat asthma. Some were mildly efficacious, while others were just plain dangerous. Oral and inhaled forms of epinephrine and ephedrine once were the only effective medications for treating asthma. Beginning in the 1980s, newer medications were introduced that target more of the abnormal conditions in asthma and do so more effectively than epinephrine or ephedrine. For example, prescription inhaler forms of short-acting beta2-agonists (SABA), including albuterol (Proventil, Ventolin, ProAir, Xopenex), and metaproterenol (Alupent), inhaled corticosteroids (ICS) including Beclovent, Flovent, Qvar, Asmanex, Asmacort, Arnuity, Pulmicort, Aerospan, Alvesco and Aerobid, anticholinergics (ipratropium, tiotropium bromide, glycopyrrolate, umeclidinium, [Atrovent], Spiriva, Incruse, Bevespi), and other medicines are now widely used because of their greater effectiveness and fewer side effects. The use of inhaled anti-inflammatory medications that include steroid agents such as fluticasone, budesonide, beclomethasone, and flunisolide has become the mainstay of initial asthma therapy. Unfortunately, none of these medications are available without a prescription. Often, these medications are also prescribed in combination with a long-acting beta agonist (LABA), such as salmeterol, formoterol, or vilanterol. Some of the more common versions include Advair, Symbicort, Dulera, and Breo.
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