Guideline Excerpt: Long-term and Quick-relief Medications
Guideline Excerpt: Long-term and Quick-relief Medications
Here is an overview of long-term and quick-relief medications, from the Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma, produced by the National Heart, Lung and Blood Institute in Bethesda, MD.
Long-term control medications
• Corticosteroids:
Most potent and effective anti-inflammatory medication currently available. Inhaled form is used in the long-term control of asthma. Systemic corticosteroids are often used to gain prompt control of the disease when initiating long-term therapy.
• Cromolyn sodium and nedocromil:
Mild to moderate anti-inflammatory medications. May be used as initial choice for long-term control therapy for children. Can also be used as preventative treatment prior to exercise or unavoidable exposure to known allergens.
• Long-acting beta-2-agonists:
Long-acting bronchodilator used concomitantly with anti-inflammatory medications for long-term control of symptoms, especially nocturnal symptoms. Also prevents exercise-induced bronchospasms.
• Methylxanthines:
Sustained-release theophylline is a mild to moderate bronchodilator used principally as adjuvant to inhaled corticosteroids for prevention of nocturnal asthma symptoms. May have mild anti-inflammatory effect.
• Leukotriene modifiers:
Zafirlukast, a leukotriene receptor antagonist, or zileuton, a 5-lipoxygenase inhibitor, may be considered an alternative therapy to low doses of inhaled corticosteroids or cromolyn or nedocromil for patients older than 12 years of age with persistent asthma, although further clinical experience and study are needed to establish their roles in asthma therapy.
Quick-relief medications
• Short-acting beta-2-agonists:
Therapy of choice for relief of acute symptoms and prevention of exercise-induced bronchospasms.
• Anticholinergics:
Ipratropium bromide may provide some additive benefit to inhaled beta-2-agonists in severe exacerbations. May be an alternative bronchodilator for patients who do not tolerate inhaled beta-2-agonists.
• Systemic corticosteroids:
Used for moderate to severe exacerbations to speed recovery and prevent recurrence of exacerbations.
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