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What is Asthma?
Definition:
1) Airway tube spasm/closing (bronchospasm) that is variable and reversible:
Airway tube open Airway tube spasm
2) Inflammation (swelling/congestion) of those airway tubes:
Normal Inflamed
Medications:
Reliever medications
1) Bronchodilator (blue):
- Names: Ventolin, salbutamol, Airomir, Bricanyl
- Reverses airway tube spasm, opens airway
- Immediate relief
- Does NOT treat underlying inflammation
- Use when needed (cough, breathless, wheeze), or before exercise
- Rescue medication
2) Long acting bronchodilator:
- Brand names: Oxeze (may be used as reliever), Servent (not to be used as reliever)
- Used regularly in addition to inhaled steroid
- Oxeze may be used when needed alone before exercise
- Caution: If you need Oxeze frequently as a reliever, you should be on a preventer medication regularly
Controller medications:
3) Inhaled steroid
3) Inhaled steroid
- Brand names: Pulmicort (brown), Flovent (orange), QVAR (red), Alvesco (red), Asmanex (pink), Arnuity (orange/white)
- Decreases airway inflammation
- Needs time to gradually decrease inflammation therefore...
... needs to be taken REGULARLY (every day) to work effectively
- Prevents further symptoms from occurring
4) Combined inhaled steroid + Long acting bronchodilator:
- Brand names: Symbicort (red), Advair (purple), Zenhale (blue), Breo (blue/white), Actectura (white)
- Decreases airway inflammation
- Needs time to gradually decrease inflammation therefore...
... needs to be taken REGULARLY (every day) to work effectively
- Prevents further symptoms from occurring
4) Combined inhaled steroid + Long acting bronchodilator:
- Brand names: Symbicort (red), Advair (purple), Zenhale (blue), Breo (blue/white), Actectura (white)
5) Triple Therapy (Inhaled steroid + Long acting bronchodilator + Long acting muscarinic antagonist (another bronchodilator))
-Enerzair (white/green), Trelegy (grey with beige top)
6) Antileukotrienes (pill):
- Brand names: Singulair, Accolate
- Useful in:
6) Antileukotrienes (pill):
- Brand names: Singulair, Accolate
- Useful in:
- Patients with asthma and hay-fever/nasal allergy symptoms
- viral-induced asthma (children)
- aspirin-induced asthma, exercise induced asthma
7) Biologic medication (prescribed by specialist):
- Omalizumab (Xolair) - Anti-IgE - injections for moderate to severe allergic asthma (and Chronic Hives)
- Mepolizumab (Nucala) and Benralizumab (Fasenra)- Injections for severe eosinophilic asthma
-Dupilumab (Dupixent)-Injections for atopic type asthmatics
-Tezepellumab (Tezspire)-Injections for any severe asthmatic