Asthma is a disease characterized by inflammation of the airways. This inflammation (or swelling) causes the airways to become “twitchy”, to constrict (become narrow) and to produce more mucous. These three things cause children with asthma to cough and occasionally to wheeze. Our goal with asthma medicines is to prevent the inflammation and thus stop the cough and/or wheeze. The cough and/or wheezing are an indication of what’s going on lower in the lungs.
Generally speaking, there are two types of asthma medications used to control asthma: rescue and maintenance medications.
Rescue medications are used for just that- a quick fix in a difficult situation. In the case of asthma, the difficult situation is that the lung airways (bronchioles) are constricted, making it hard to breathe. Bronchodilators are medicines that will open up the lung airways and thus make it easier to breathe. They work quickly (in 10-15 minutes) but their effect doesn’t last very long (3-4 hours). They can either be given by a nebulizer or by a metered dose inhaler (MDI or “puffer”). Two common rescue medicines are AlbuterolTM and XopenexTM.
Maintenance medicines are medicines used to prevent asthma flares and to keep the inflammation process in the lungs at bay. When the lung tissues are continually inflamed from the asthma process, the child is prone to recurrent flare-ups. Inhaled corticosteroids (ICS) are effective maintenance medicines; two examples are PulmicortTM and FloventTM. ICS medicines may take 7 days or longer to begin preventing asthma symptoms from occurring. Likewise, if a child misses a dose of his/her ICS medicine, he/she may not notice a change in symptoms; the temptation here is to assume that the ICS medicine is not needed. This is NOT the case! Since the ICS medicines take a long time building up in the body, their effect will also be noticed for awhile after the medicine is stopped. DO NOT STOP TAKING YOUR MAINTENANCE MEDICINE UNLESS YOUR PHYSICIAN TELLS YOU TO DO SO. Stopping your maintenance medicine may lead to an asthma flare-up!
There are several other maintenance medications available. The Asthma Nurse Educator and your physician will review these with you if your child needs another medicine to manage his/her asthma.