What medications are best for the treatment of asthma? What are their side effects?
What medications are best for the treatment of asthma? What are their side effects?
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Inhaled Corticosteroids
Inhaled corticosteroids (commonly known as inhaled steroids) are prescribed to help prevent the symptoms of asthma. When used regularly, they help decrease the frequency and severity of asthma attacks. However, they will not relieve an attack once it has started.
Inhaled corticosteroids can cause both local side effects (limited to a part of the body) and systemic side effects (affecting the entire body). Systemic effects tend to be more severe and are typically associated with long-term use. Among the possible side effects:1
Oral candidiasis (thrush), a common fungal infection of the mouth
Dysphonia (hoarseness), usually short-term
Sore mouth or throat
A reflex cough or spasms of the trachea (windpipe)
A slight reduction in growth in children
Decreased bone density in adults
Easy bruising
Clouding of the eye (cataract)
Increased pressure in the eye (glaucoma)
The use of a spacer can often relieve some of the local side effects. Rinsing and gargling following use of inhaled corticosteroids will help to prevent local adverse effects, such as hoarseness and oral thrush (yeast infection of the mouth)
Short and Long-Acting Beta Antagonists
Short-acting beta antagonists (SABAs) like albuterol are typically used as rescue medications to provide the quick relief of asthma symptoms. By contrast, long-acting beta-agonists (LABAs) continue to work for 12 hours or more. The side effects are much the same since the two drugs share similar mechanisms of action. Side effects include:3
Increased heart rate
Headache
Dizziness
Anxiety
Nervousness or tremors
Rash
While the side effects resolve quickly with SABAs, they can often persist with LABAs. A similar effect occurs when beta antagonists are used excessively.
While the overuse of a rescue inhaler can increase your risk of a severe attack, that risk is multiplied if you overuse a LABA, leading the FDA to issue a black box warning about the risk of fatal asthma attacks when using the drug Advair (fluticasone/salmeterol)
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ASTHMA TREATMENT
Asthma Medication Side Effects
By Pat Bass, MD Medically reviewed by a board-certified physician Updated on May 09, 2019
A man using his inhaler on a hike
burakkarademir / Getty Images
As with all drugs, there are a number of side effects associated with asthma medications. In most cases, the drugs will be well tolerated, and the benefits of treatment will far outweigh the consequences. There may be times, however, when a side effect may be more severe.
By and large, people who understand the side effects of a drug before they take it will be less likely to quit if one happens. At the same time, it allows them to spot serious symptoms and get them treated before it becomes a problem.
The types of medication used to treat asthma are as diverse as the symptoms and include inhaled corticosteroids, short- and long-acting relief medications, oral steroids, leukotriene modifiers, mast cell stabilizers, and immune modulators.
Inhaled Corticosteroids
Inhaled corticosteroids (commonly known as inhaled steroids) are prescribed to help prevent the symptoms of asthma. When used regularly, they help decrease the frequency and severity of asthma attacks. However, they will not relieve an attack once it has started.
Inhaled corticosteroids can cause both local side effects (limited to a part of the body) and systemic side effects (affecting the entire body). Systemic effects tend to be more severe and are typically associated with long-term use. Among the possible side effects:1
Oral candidiasis (thrush), a common fungal infection of the mouth
Dysphonia (hoarseness), usually short-term
Sore mouth or throat
A reflex cough or spasms of the trachea (windpipe)
A slight reduction in growth in children
Decreased bone density in adults
Easy bruising
Clouding of the eye (cataract)
Increased pressure in the eye (glaucoma)
The use of a spacer can often relieve some of the local side effects. Rinsing and gargling following use of inhaled corticosteroids will help to prevent local adverse effects, such as hoarseness and oral thrush (yeast infection of the mouth).2
Short and Long-Acting Beta Antagonists
Short-acting beta antagonists (SABAs) like albuterol are typically used as rescue medications to provide the quick relief of asthma symptoms. By contrast, long-acting beta-agonists (LABAs) continue to work for 12 hours or more. The side effects are much the same since the two drugs share similar mechanisms of action. Side effects include:3
Increased heart rate
Headache
Dizziness
Anxiety
Nervousness or tremors
Rash
While the side effects resolve quickly with SABAs, they can often persist with LABAs. A similar effect occurs when beta antagonists are used excessively.
While the overuse of a rescue inhaler can increase your risk of a severe attack, that risk is multiplied if you overuse a LABA, leading the FDA to issue a black box warning about the risk of fatal asthma attacks when using the drug Advair (fluticasone/salmeterol).4
Oral Steroids Side Effects
Oral steroids are typically used if you have had or are at risk of a serious attack. While steroids are delivered intravenously in a hospital setting, they are given in oral form if your symptoms are severe but do not require hospitalization. Side effects are similar to those for inhaled steroids, albeit more common and severe. They can include:5
Weight gain
Fluid retention
High blood pressure
Elevated blood sugar
Growth suppression in children
Osteoporosis in adults
Muscle weakness
Cataracts and glaucoma
Diabetes
If you require an oral steroid like prednisone two or more times per year, your asthma is not being well controlled. See your doctor and explore if any changes need to be made to your medication doses or drug combination.
Leukotriene Modifiers
Singulair (montelukast) and other leukotriene modifiers work by blocking a substance, called leukotriene, which can trigger an asthma attack. Leukotriene modifiers are generally well tolerated but do have a number of common side effects, including:6
Stomach upset
Headache
Flu-like symptoms
Nervousness
Nausea or vomiting
Nasal congestion
Rash