8. Type Drugs For Treating Asthma
Most asthma medications work by relaxing the broncho spasm / bronchospasm (bronchodilators) or reducing inflammation (corticosteroids). In the treatment of asthma, inhaled medications are generally preferred over tablet or liquid medicine that is swallowed (oral medications). Inhaled medications act directly on the surface and airway muscles where the asthma problems began. Absorption of inhaled medications into the rest of the body is small. Therefore, the side effects are less unfavorable than drugs taken (oral medications). Inhaled medications including beta-2 agonists, anticholinergics, corticosteroids, and cromolyn sodium. Oral medications include aminophylline, leukotriene antagonists, and corticosteroid tablets.
Historically, one of the first drugs used for asthma ynag is adrenaline (epinephrine). Adrenaline has a rapid initial action in opening the airways (bronchodilation). He is still often used in emergency situations asthma. Unfortunately, adrenaline has many side effects, including rapid heartbeat, headache, nausea, vomiting, restlessness, and a sense of panic.
Drugs that are chemically similar to adrenaline has been developed. These drugs, called beta-2 agonists, have the advantage of broncho dilation of adrenaline without many of these effects are not dikehandaki sampinganya. Beta-2 agonists are inhaled bronchodilators called "agonists" because they promote the work of the beta-2 receptor of the muscles of the bronchial walls. Receptor works by relaxing the muscular walls of the airways (bronchi), producing bronchodilation (bronchodilation). Work bronchodilation of beta-2 agonists starts within minutes after inhalation and lasts for about 4 hours. Examples of these medications include albuterol (Ventolin, Proventil), metaproterenol (Alupent), pirbuterol acetate (MAXair), and terbutaline sulfate (Brethaire).
A new group of beta-2 agonists that works long been developed with a sustained duration of effect of 12 hours. Inhaler inhaler can be used twice a day. Salmeterol xinafoate (Serevent) is an example of this group of drugs. Beta-2 agonists are working length is generally not used for acute attacks. Beta-2 agonists can have side effects, such as fear, shaking (tremor), palpitations or rapid heart rate, and decreased blood potassium
As with beta-2 agonists can enlarge the airways, beta blocker drugs block the relaxation of bronchial muscles by beta-2 receptors and can cause constriction of the airways, aggravating asthma. Therefore, beta blockers, such as blood pressure medication propranolol (Inderal) and atenolol (Tenormin), should be avoided by patients with asthma if possible.
Anticholinergic agents working on the type of nerves that is different from beta-2 agonists to achieve a relaxation and opening of the airway passages are similar. Both groups of bronchodilator inhalers when used together can result in an increase in bronchodilation effect. An example of a commonly used anticholinergic agent is ipratropium bromide (Atrovent). Ipratropium takes longer to work than the beta-2 agonists, with peak effectiveness occurring two hours after intake and lasted for six hours. Anticholinergic agents as well as the drug may be helpful to patients with emphysema.
When asthma symptoms are difficult to control with beta-2 agonists, inhaled corticosteroids (cortisone) are often added. Corticosteroids can improve lung function and reduce airway barriers over time. Examples of inhaled corticosteroids include beclomethasone dipropionate (Beclovent, Beconase, Vancenase, and Vanceril), triamcinolone acetonide (Azmacort) and flunisolide (Aerobid). The ideal dose of corticosteroids is still unknown. The side effects of inhaled corticosteroids include hoarseness, loss of voice, and oral yeast infections. Early use of inhaled corticosteroids may prevent irreversible damage to the airways.
Cromolyn sodium (Intal) prevents the release of certain chemicals in the lungs, such as histamine, which can cause asthma. Exactly how cromolyn works to prevent asthma needs further research. Cromolyn is not a corticosteroid and is usually not associated with side effects are significant. Cromolyn is useful in preventing asthma but has limited effectiveness once acute asthma starts. Cromolyn may help prevent asthma triggered by exercise, cold air, and allergic substances, such as cat dander. Cromolyn may be used both in children and in adults.
Theophylline (Theodur, Theoair, Slo-bid, Uniphyl, Theo-24) and aminophylline are examples of methylxanthines. Methylxanthines are administered orally (by mouth) or by injection through a vein (intravenously). Before inhalers became popular, methylxanthines were the mainstay of asthma treatment. Caffeine in common coffee and soft drinks (soft drinks) is also a methylxanthine drug! Theophylline relaxes the muscles surrounding the air passages and prevents certain cells lining the bronchi (mast cells) from the release of chemicals, such as histamine, which can cause asthma. Theophylline may also work as a mild diuretic, causing increased urine expenditures. For asthma that is difficult to control, methylxanthines can still play an important role. Dosage levels of theophylline or aminophylline are closely monitored. Excessive levels can lead to nausea, vomiting, heart rhythm problems, and even heart attacks. In certain medical conditions, such as heart failure or cirrhosis, dosages of methylxanthines are lowered to prevent blood levels are excessive. Drug interactions with other medications, such as cimetidine (Tagamet), calcium channel blockers (Procardia), quinolones (Cipro), and allopurinol (Xyloprim) can further affect drug levels in the blood.
Corticosteroids are given orally (by mouth) for severe asthma unresponsive to other drugs. Unfortunately, high doses of corticosteroids for a long period of time can have side effects are serious, including osteoporosis, broken / fractured bones, diabetes mellitus, hypertension, skin thinning and bruising, insomnia (trouble sleeping), changes -emotional changes, and weight gain
Expectorants help thin mucus-airway mucus, making it easier to clear mucus by coughing. Potassium iodide is generally not used and have side effects that have the potential for acne, increased salivation, hives, and thyroid problems. Guaifenesin (Entex, Humibid) can increase the production of fluid in the lungs and help thin the mucus-mucus, but can also be an airway irritant for some people.
In addition to bronchodilator medications for patients with atopic asthma (atopic asthma), avoiding allergens or other irritants can be very important. In patients who can not avoid the allergens, or those whose symptoms can not be controlled by medication, allergy shots are considered. The advantages of allergy shots (desensitization) in the prevention of asthma is still not firmly established. Some doctors are concerned about the risk of anaphylaxis, which occurs in about one in 2 million doses given. Allergy shots are generally the most benefit children allergic to mites-mites (house dust mites). Other benefits can be seen in the pollen and animal dander.
In some asthma patients, avoidance of aspirin or other NSAIDs (commonly used in the treatment of inflammatory arthritis) is important. In other patients, adequate treatment of backflow of stomach acid (esophageal reflux) to prevent irritation of the airways. Measures to prevent esophageal reflux include medications, weight loss, dietary changes, and stop smoking, coffee and alcohol. Examples of drugs that are used to reduce reflux include omeprazole (Prilosec) and ranitidine (Zantac). Patients with severe reflux issues causing problems lungs may require surgery to strengthen the lower esophageal sphincter in order to prevent acid reflux (fundoplication surgery). For more information please read the article about the disease Gastroesophageal Reflux.